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CH03182C CABIN CREEK HEALTH CENTER, INC. (Active)
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Main Details
Name
CABIN CREEK HEALTH CENTER, INC.
Subdivision Name
Clendenin Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-011055
340B ID
CH03182C
Grant Number
H80CS00294
Additional Details
Current Program Status
Active
Registration Date
6/2/2010
Participating Start Date
7/1/2010
Participating Approval Date
6/3/2010
Last Recertification Date
2/17/2025
Contacts
Authorizing Official
Cabin Creek Health Systems
Amber Renee Crist, Chief Operating Officer
(304) 444-2146
Primary Contact
Cabin Creek Health Systems
Jerad Lee Bailey, Director of Pharmacy Operations
(304) 734-2040 Ext: 1324
Addresses
Street Address
107 Koontz Ave
STE 200
Clendenin, WV 25045-0667
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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11/4/11 - Entered NPI #.
11/04/2011
May 2025
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