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CH05203N CHERRY STREET SERVICES, INC. (Terminated)
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Main Details
Name
CHERRY STREET SERVICES, INC.
Subdivision Name
SCHOOL MEDICAL PROGRAM
Type
HRSA-Funded Health Center
Site ID
BPS-H80-000152
340B ID
CH05203N
Grant Number
H80CS00770
Additional Details
Current Program Status
Terminated
Registration Date
12/4/2006
Participating Start Date
1/1/2007
Participating Approval Date
12/5/2006
Last Recertification Date
2/8/2018
Termination Date
Termination Reason
1/1/2019
Business decision by the Covered Entity
Contacts
Authorizing Official
Cherry Street Services Inc
Tasha Blackmon, CEO
(616) 965-8215
Primary Contact
Cherry Street Services Inc
Brett Gingrich, Pharmacy Director
(616) 965-8278 Ext: 7139
Addresses
Street Address
669 STOCKING NW
GRAND RAPIDS, MI 49504
Billing Address
CHERRY STREET SEVICES, INC
100 CHERRY STREET SE
GRAND RAPIDS, MI 49503
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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2/16/12-CHANGED BILLING ADDRESS-WAS 669 STOCKING NW.
02/16/2012
June 2025
June 2025
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