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CH083800 Midtown Community Health Center, Inc. (Active)
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Main Details
Name
Midtown Community Health Center, Inc.
Subdivision Name
MIDTOWN COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-003548
340B ID
CH083800
Grant Number
H80CS00831
Additional Details
Current Program Status
Active
Registration Date
1/1/2004
Participating Start Date
1/1/2004
Participating Approval Date
10/10/2003
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Midtown Community Health Center
Alicia Martinez, Chief Executive Officer
(801) 334-1321
Primary Contact
Midtown Community Health Center
Braden D. Mitchell, Pharmacy Director
(801) 395-8200
Addresses
Street Address
2240 Adams Ave
Ogden, UT 84401-1511
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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6/5/06 - ADDED MEDICAID #, 5/24/06 - ADDRESS CHANGE (WAS 670 28TH STREET)
06/06/2006
May 2025
May 2025
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