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CH01058A PROVIDENCE COMMUNITY HEALTH CENTERS, INC., THE (Active)
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Main Details
Name
PROVIDENCE COMMUNITY HEALTH CENTERS, INC., THE
Subdivision Name
Providence Community Health Center at Prairie Avenue
Type
HRSA-Funded Health Center
Site ID
BPS-H80-011771
340B ID
CH01058A
Grant Number
H80CS00057
Additional Details
Current Program Status
Active
Registration Date
7/1/1996
Participating Start Date
7/1/1996
Participating Approval Date
2/25/2004
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
PCHC
MERRILL THOMAS, CEO
(401) 444-0400 Ext: 3130
Primary Contact
Providence Community Health Centers
Garrett Clark, CO
(401) 444-0400
Addresses
Street Address
355 Prairie Ave
Providence, RI 02905-1928
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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UPDATED CONTACT INFO
08/11/2005
May 2025
May 2025
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