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CH03715D RICHMOND, CITY OF (Active)
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Main Details
Name
RICHMOND, CITY OF
Subdivision Name
Northside Medical Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-004875
340B ID
CH03715D
Grant Number
H80CS00174
Additional Details
Current Program Status
Active
Registration Date
3/10/2008
Participating Start Date
4/1/2008
Participating Approval Date
3/11/2008
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Vernon J Harris
Tracy Causey, CEO
(804) 253-1968
Primary Contact
Capital Area Health Network
Nickie Falero-Hicks, CNO
(804) 780-0840
Addresses
Street Address
2809 North Ave STE 206
Richmond, VA 23222
Billing Address
CAPITAL AREA HEALTH NETWORK
PO Box 27947
RICHMOND, VA 23261
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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12/1/11 UPDATED SUB-DIV NAME (WAS NORTHSIDE MEDICAL CENTER), ADDED BILL-TO ADD
12/01/2010
April 2025
April 2025
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