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CH04563E GASTON FAMILY HEALTH SERVICES INC (Terminated)
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Main Details
Name
GASTON FAMILY HEALTH SERVICES INC
Subdivision Name
OPEN DOOR DENTISTRY
Type
HRSA-Funded Health Center
Site ID
BPS-H80-003067
340B ID
CH04563E
Grant Number
H80CS00293
Additional Details
Current Program Status
Terminated
Registration Date
9/14/2009
Participating Start Date
10/1/2009
Participating Approval Date
9/18/2009
Last Recertification Date
2/22/2016
Termination Date
Termination Reason
7/1/2016
Site closure
Contacts
Authorizing Official
Gaston Family Health Services
Robert Spencer, CEO
(704) 616-2245
Primary Contact
Gaston Family Health Services
Robert Spencer, CEO
(704) 616-2245
Addresses
Street Address
425 Wilmington Ave
Statesville, NC 28677-7078
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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