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FQHCLA211A HEALTH CENTERS DETROIT MEDICAL GROUP (Active)
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Main Details
Name
HEALTH CENTERS DETROIT MEDICAL GROUP
Subdivision Name
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-017140
340B ID
FQHCLA211A
Grant Number
LALCS00008
Additional Details
Current Program Status
Active
Registration Date
12/1/2006
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
HCDF, Inc.
AUDREY ECTOR, EXECUTIVE ASSISTANT
(313) 966-5187
Addresses
Street Address
23077 GREENFIELD ROAD, SUITE 400
SOUTHFIELD, MI 48075
Billing Address
HEALTH CENTERS DETROIT MEDICAL GROUP-ADMINISTRATION
4201 ST ANTOINE BLVD, UHC-9D
DETROIT, MI 48201-2153
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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8/26/2008- ADDED BILLING ADDRESS.
12/01/2006
May 2025
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