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CHC08772-02 GRACEMED HEALTH CLINIC, INC. (Active)
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Main Details
Name
GRACEMED HEALTH CLINIC, INC.
Subdivision Name
GraceMed Healthy Family Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-004593
340B ID
CHC08772-02
Grant Number
H80CS08772
Additional Details
Current Program Status
Active
Registration Date
9/18/2009
Participating Start Date
4/1/2005
Participating Approval Date
9/18/2009
Last Recertification Date
2/14/2025
Contacts
Authorizing Official
GraceMed Health Clinic
Julie Elder, CEO
(316) 866-2000 Ext: 2066
Primary Contact
GraceMed Health Clinic
David Wuthnow, CFO
(316) 866-2049
Addresses
Street Address
1905 S Laura St
Wichita, KS 67211-3211
Billing Address
GRACEMED HEALTH CLINIC, INC.
1122 N. TOPEKA
WICHITA, KS 67214
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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6/21/10 ADDED BILL TO
06/21/2010
May 2025
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