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CH011830 CHARTER OAK HEALTH CENTER (Active)
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Main Details
Name
CHARTER OAK HEALTH CENTER
Subdivision Name
CHARTER OAK HEALTH CENTER, INC.
Type
HRSA-Funded Health Center
Site ID
BPS-H80-005005
340B ID
CH011830
Grant Number
H80CS00153
Additional Details
Current Program Status
Active
Registration Date
1/1/2004
Participating Start Date
1/1/2004
Participating Approval Date
11/29/2004
Last Recertification Date
2/2/2024
Contacts
Authorizing Official
Charter Oak Health Center
Nichele A. Mullins, President and CEO
(860) 550-7578
Primary Contact
Charter Oak Health Center
Tim Powers, Vice President of Compliance
(860) 550-7500 Ext: 6214
Addresses
Street Address
21 Grand St
Hartford, CT 06106-1541
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; 11/29/04 - ADDED MEDICAID #
11/29/2004
June 2024
June 2024
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