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CH0627970 AMISTAD COMMUNITY HEALTH CENTER (Active)
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Main Details
Name
AMISTAD COMMUNITY HEALTH CENTER
Subdivision Name
AMISTAD COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-003511
340B ID
CH0627970
Grant Number
H80CS08778
Additional Details
Current Program Status
Active
Registration Date
8/17/2008
Participating Start Date
4/1/2014
Participating Approval Date
8/22/2008
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
Amistad Community Health Center
Eric Baggerman, CEO
(361) 960-9052
Primary Contact
Amistad Community Health Center Inc
Leo Trevino, Staff Accountant
(361) 886-3033
Addresses
Street Address
1533 S Brownlee Blvd
Corpus Christi, TX 78404-3131
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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Is Suong an employee of Amistad?
07/15/2024
2/25/14 participating 9/1/08 thru 3/31/13, not participating 4/1/13 thru 3/31/14 due to failure to recertify, re-instated based on new registration submitted in Jan. 2014
02/05/2015
May 2025
May 2025
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