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CH011890 Charles River Community Health at 495 Western Ave (Active)
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Main Details
Name
Charles River Community Health at 495 Western Ave
Subdivision Name
Type
HRSA-Funded Health Center
Site ID
BPS-H80-011369
340B ID
CH011890
Grant Number
H80CS00378
Additional Details
Current Program Status
Active
Registration Date
4/1/2004
Participating Start Date
4/1/2004
Participating Approval Date
3/17/2004
Last Recertification Date
2/27/2025
Contacts
Authorizing Official
Charles River Community Health
Matthew L. Mullaney, Chief Executive Officer
(781) 400-6221
Primary Contact
Charles River Community Health
Benjamin Sturm, Director of Pharmacy
(617) 870-7448
Addresses
Street Address
495 Western Avenue
Brighton, MA 02135
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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12/31/15 Site ID updated, needed due to 10/21/15 address update; 8/27/09 MEDI # ADDED - NEW SITE 04/01/2004
12/31/2015
8/27/09 MEDI # ADDED - NEW SITE 04/01/2004
08/27/2009
April 2025
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