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CH05332AB SIHF Healthcare (Terminated)
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Main Details
Name
SIHF Healthcare
Subdivision Name
SIHF Good Samaritan Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-007554
340B ID
CH05332AB
Grant Number
H80CS00195
Additional Details
Current Program Status
Terminated
Registration Date
9/2/2008
Participating Start Date
9/4/2008
Participating Approval Date
9/4/2008
Last Recertification Date
2/9/2018
Termination Date
Termination Reason
4/1/2019
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
815 E 5th St
Alton, IL 62002-6471
Billing Address
SIHF Healthcare
2041 Goose Lake Road
Sauget, IL 62206
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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6/21/10 ADDED SUBDIV NAME AND ADDED SUITE # TO ADDR
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