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CH043823A BREVARD HEALTH ALLIANCE INC., THE (Active)
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Main Details
Name
BREVARD HEALTH ALLIANCE INC., THE
Subdivision Name
BHA Melbourne Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-007839
340B ID
CH043823A
Grant Number
H80CS04213
Additional Details
Current Program Status
Active
Registration Date
4/1/2005
Participating Start Date
4/1/2005
Participating Approval Date
3/9/2005
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Brevard Health Alliance
Austin Helton, CEO
(321) 241-6854
Primary Contact
Brevard Health Alliance
Reem Natafji, Chief Pharmacy Officer
(321) 342-9706
Addresses
Street Address
17 Silver Palm Avenue
Melbourne, FL 32901-3123
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 4/01/051281 2/19/09 - KB - SUB DIVISION NAME AND PHYSICAL ADDRESS CHANGE(WAS HICKORY CLINICS. HICKORY STREET, SUITE A)
02/19/2009
May 2025
May 2025
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