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CH05744I PCC COMMUNITY WELLNESS CENTER (Terminated)
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Main Details
Name
PCC COMMUNITY WELLNESS CENTER
Subdivision Name
PCC West Town Family Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-012730
340B ID
CH05744I
Grant Number
H80CS00276
Additional Details
Current Program Status
Terminated
Registration Date
8/29/2008
Participating Start Date
9/2/2008
Participating Approval Date
9/2/2008
Last Recertification Date
2/3/2021
Termination Date
Termination Reason
7/1/2021
Site closure
Contacts
Authorizing Official
PCC Community Wellness Center
Robert Urso, President & CEO
(708) 524-7686
Primary Contact
PCC Community Wellness Center
Patrick R Garrick, Chief Financial Officer
(708) 383-0113 Ext: 7340
Addresses
Street Address
1044 N Mozart St STE 100
Chicago, IL 60622-2789
Billing Address
PCC COMMUNITY WELLNESS CENTER
14 LAKE STREET
OAK PARK, IL 60302
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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