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CH045630 GASTON FAMILY HEALTH SERVICES INC (Active)
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Main Details
Name
GASTON FAMILY HEALTH SERVICES INC
Subdivision Name
Kintegra Family Medicine - Hudson
Type
HRSA-Funded Health Center
Site ID
BPS-H80-001955
340B ID
CH045630
Grant Number
H80CS00293
Additional Details
Current Program Status
Active
Registration Date
10/1/1997
Participating Start Date
10/1/1997
Participating Approval Date
5/19/2005
Last Recertification Date
3/5/2025
Contacts
Authorizing Official
Gaston Family Health Services
Robert Spencer, CEO
(704) 616-2245
Primary Contact
Gaston Family Health Services, Inc.
Marvin Patrick Allen, Director, Pharmacy Services
(704) 772-4642
Addresses
Street Address
991 W Hudson Blvd
Gastonia, NC 28052-6430
Billing Address
Gaston Family Health Services, Inc.
200 East Second Avenue
Gastonia, NC 28052
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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3/22/10 - UPDATED PHYS ADD (WAS 105 DAVE WARLICK DR, LINCOLNTON), ADDED NPI #1215932215; 3/12/10 - UPDATED PHYS ADD (WAS 991 WEST HUDSON BLVD, GASTONIA, NC 28052), ADDED NPI #; 3/21/05 - ADMIN CORRECTION - REPLACES FQHCLA033, 5/19/05 - ADDED MEDICAID #
03/22/2010
May 2025
May 2025
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