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FQHCLA251 CITY OF CINCINNATI DEPT OF HEALTH (Terminated)
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Main Details
Name
CITY OF CINCINNATI DEPT OF HEALTH
Subdivision Name
PRICE HILL HEALTH CENTER
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-009735
340B ID
FQHCLA251
Grant Number
LALCS00023
Additional Details
Current Program Status
Terminated
Registration Date
11/17/2009
Participating Start Date
1/1/2010
Participating Approval Date
12/2/2009
Last Recertification Date
2/19/2015
Termination Date
Termination Reason
10/1/2015
Change of covered entity type
Contacts
Authorizing Official
JEFFREY BUKA, PHARMACY DIRECTOR
(513) 352-3801
Primary Contact
JEFFREY BUKA, PHARMACY DIRECTOR
(513) 352-3801
Addresses
Street Address
2136 WEST EIGHTH STREET
CINCINNATI, OH 45204
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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