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CH04065C PARK DUVALLE COMMUNITY HEALTH CENTER, INC. (Active)
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Main Details
Name
PARK DUVALLE COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Buechel/Newburg Community Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-036166
340B ID
CH04065C
Grant Number
H80CS00083
Additional Details
Current Program Status
Active
Registration Date
10/1/2004
Participating Start Date
10/1/2004
Participating Approval Date
8/23/2004
Last Recertification Date
2/12/2025
Contacts
Authorizing Official
PARK DUVALLE COMMUNITY HEALTH CENTER
Swannie Jett, CEO
(502) 774-4401
Primary Contact
Park Duvalle Community Health Center
Antonio Lavelle Booker, Director of Pharmacy
(502) 774-4401 Ext: 1130
Addresses
Street Address
3828 Bardstown Road
Louisville, KY 40218-2203
Billing Address
PARK DUVALLE COMMUNITY HEALTH CENTER, INC.
3015 Wilson Ave
Louisville, KY 40211-1999
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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NEW SITE 10/01/2004
08/12/2005
May 2025
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