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CH07170F FAMILY CARE HEALTH CENTERS (Active)
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Main Details
Name
FAMILY CARE HEALTH CENTERS
Subdivision Name
FOREST PARK SOUTHEAST
Type
HRSA-Funded Health Center
Site ID
BPS-H80-003663
340B ID
CH07170F
Grant Number
H80CS00492
Additional Details
Current Program Status
Active
Registration Date
5/22/2014
Participating Start Date
7/1/2014
Participating Approval Date
6/5/2014
Last Recertification Date
2/18/2025
Contacts
Authorizing Official
Family Care Health Centers
Aramide Ayorinde, Chief Executive Officer
(314) 481-1615 Ext: 1315
Primary Contact
Family Care Health Centers
Kevin L. Maddox, Chief Financial Officer
(314) 481-1615 Ext: 1306
Addresses
Street Address
4352 MANCHESTER AVE
ST. LOUIS, MO 63110-2138
Billing Address
FAMILY CARE HEALTH CENTERS
401 HOLLY HILLS
ST LOUIS, MO 63111
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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6/5/14 participating 4/1/06 thru 3/31/14, not participating 4/1/14 thru 6/30/14 due to entity's choice to terminate the record during recertification, re-instated based on on-line registration submitted in May 2014
06/05/2014
May 2025
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