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CH041349C EAST TENNESSEE STATE UNIVERSITY (Active)
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Main Details
Name
EAST TENNESSEE STATE UNIVERSITY
Subdivision Name
Johnson City Community Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-012065
340B ID
CH041349C
Grant Number
H80CS00840
Additional Details
Current Program Status
Active
Registration Date
9/1/2005
Participating Start Date
9/9/2005
Participating Approval Date
9/1/2005
Last Recertification Date
2/14/2025
Contacts
Authorizing Official
East Tennessee State University
Melissa Queen, Business Director
(423) 439-4076
Primary Contact
East Tennessee State University
Andrea Erb, Pharmacist
(423) 926-2500
Addresses
Street Address
2151 Century Lane
Johnson City, TN 37604
Billing Address
EAST TENNESSEE STATE UNIVERSITY COLLEGE OF NURSING
400 JL Seehorn Road
Johnson City, TN 37614
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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4/25/06 - ADDR CHANGE (WAS 202 W. FAIRVIEW AVENUE)
04/25/2006
June 2025
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