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CH07530B FAMILY HEALTH CENTER OF BOONE COUNTY (Terminated)
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Main Details
Name
FAMILY HEALTH CENTER OF BOONE COUNTY
Subdivision Name
FAMILY DENTAL CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-008201
340B ID
CH07530B
Grant Number
H80CS00573
Additional Details
Current Program Status
Terminated
Registration Date
5/29/2009
Participating Start Date
7/1/2009
Participating Approval Date
6/9/2009
Last Recertification Date
1/28/2020
Termination Date
Termination Reason
1/1/2021
Other
Contacts
Authorizing Official
Family Health Center of Boone County
Jack Kelly, Chief Executive Officer
(573) 886-6713
Primary Contact
Family Health Center of Boone County
Darren L Stice, Chief Financial Officer
(573) 886-6714
Addresses
Street Address
1101 NORTH PROVIDENCE ROAD
COLUMBIA, MO 65203
Billing Address
FAMILY HEALTH CENTER OF BOONE COUNTY
1001 W. WORLEY
COLUMBIA, MO 65203-2037
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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