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CH05332U Southern Illinois Health Care Foundation, Inc. (Terminated)
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Main Details
Name
Southern Illinois Health Care Foundation, Inc.
Subdivision Name
MADISON HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-003717
340B ID
CH05332U
Grant Number
H80CS00195
Additional Details
Current Program Status
Terminated
Registration Date
12/13/2007
Participating Start Date
1/1/2008
Participating Approval Date
12/14/2007
Last Recertification Date
2/13/2017
Termination Date
Termination Reason
4/1/2017
Site closure
Contacts
Authorizing Official
SIHF Healthcare
Larry McCulley, President
(618) 332-0694 Ext: 155
Primary Contact
SIHF Healthcare
Patrice M Howard, Senior Vice President
(618) 332-0694
Addresses
Street Address
304 Madison Ave
Madison, IL 62060-1110
Billing Address
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION (SIHF)
8080 STATE STREET
EAST ST LOUIS, IL 62203
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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4/24/12 Changed contact from Tom Daengsurisri.
04/24/2012
May 2025
May 2025
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