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FQHCLA211 HEALTH CENTERS DETROIT MEDICAL GROUP (Active)
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Main Details
Name
HEALTH CENTERS DETROIT MEDICAL GROUP
Subdivision Name
ADMINISTRATIVE
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-009712
340B ID
FQHCLA211
Grant Number
LALCS00008
Additional Details
Current Program Status
Active
Registration Date
11/29/2006
Participating Start Date
1/1/2007
Participating Approval Date
12/4/2006
Last Recertification Date
3/5/2025
Contacts
Authorizing Official
HCDF, Inc.
HERBERT C. SMITHERMAN, PRESIDENT AND CEO
(313) 966-5187
Primary Contact
Health Centers Detroit Foundation, Inc.
Andrew S Dignan, CAO, CIO
(313) 966-5187
Addresses
Street Address
4201 ST ANTOINE BLVD, 9D
DETROIT, MI 48201-2153
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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9/25/2008-UPDATED ADD. (WAS UHC-7A)
11/29/2006
April 2025
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