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CH04563D GASTON FAMILY HEALTH SERVICES INC (Active)
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Main Details
Name
GASTON FAMILY HEALTH SERVICES INC
Subdivision Name
Kintegra Family Medicine - Highland
Type
HRSA-Funded Health Center
Site ID
BPS-H80-010157
340B ID
CH04563D
Grant Number
H80CS00293
Additional Details
Current Program Status
Active
Registration Date
9/14/2009
Participating Start Date
10/1/2009
Participating Approval Date
9/18/2009
Last Recertification Date
2/26/2025
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
609 N Highland St
Gastonia, NC 28052-2179
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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11/4/10 UPDATED PHYS ADD (WAS 430-A WEST FRANKLIN BLVD, GASTONIA), ADD NPI #, UPDATE MEDICAID # (WAS 0366279)
11/04/2010
April 2025
April 2025
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