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CH102480 COWLITZ FAMILY HEALTH CENTER (Active)
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Main Details
Name
COWLITZ FAMILY HEALTH CENTER
Subdivision Name
COWLITZ FAMILY HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-004562
340B ID
CH102480
Grant Number
H80CS00542
Additional Details
Current Program Status
Active
Registration Date
1/1/2004
Participating Start Date
1/1/2004
Participating Approval Date
10/21/2003
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
Cowlitz Family Health Center
JIm Coffee, CEO
(360) 636-3892
Primary Contact
Cowlitz Family Health Center
Jim Merrill, CFO
(360) 636-3892
Addresses
Street Address
1057 12th Ave
Longview, WA 98632-2509
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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NEW SITE 01/01/2004
10/21/2003
April 2025
April 2025
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