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CH0514720 RAPHAEL HEALTH CENTER, Inc. (Active)
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Main Details
Name
RAPHAEL HEALTH CENTER, Inc.
Subdivision Name
RAPHAEL HEALTH CENTER, Inc.
Type
HRSA-Funded Health Center
Site ID
BPS-H80-005251
340B ID
CH0514720
Grant Number
H80CS00266
Additional Details
Current Program Status
Active
Registration Date
7/1/2004
Participating Start Date
7/1/2004
Participating Approval Date
6/22/2004
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Raphael Health Center, Inc.
Sherry Gray, Chief Executive Officer
(317) 860-3962
Primary Contact
Raphael Health Center
Fernando Luna, Quality Improvement Coordinator
(317) 860-3971
Addresses
Street Address
401 E 34th St
Indianapolis, IN 46205-3754
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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07/01/2004
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