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CH05332BX Southern Illinois Health Care Foundation, Inc. (Terminated)
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Main Details
Name
Southern Illinois Health Care Foundation, Inc.
Subdivision Name
Central Collinsville Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-011932
340B ID
CH05332BX
Grant Number
H80CS00195
Additional Details
Current Program Status
Terminated
Registration Date
11/25/2009
Participating Start Date
1/1/2010
Participating Approval Date
12/3/2009
Last Recertification Date
2/13/2017
Termination Date
Termination Reason
4/1/2017
Site closure
Contacts
Authorizing Official
SIHF Healthcare
Larry McCulley, President
(618) 332-0694 Ext: 155
Primary Contact
SIHF Healthcare
Patrice M Howard, Senior Vice President
(618) 332-0694
Addresses
Street Address
80 Burlington Street
Collinsville, IL 62234-4931
Billing Address
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION (SIHF)
8080 STATE STREET
EAST ST. LOUIS, IL 62203
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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