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CH04563H GASTON FAMILY HEALTH SERVICES, INC. (Terminated)
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Main Details
Name
GASTON FAMILY HEALTH SERVICES, INC.
Subdivision Name
GFHS Cherryville – Adult and Pediatric Medicine
Type
HRSA-Funded Health Center
Site ID
BPS-H80-009409
340B ID
CH04563H
Grant Number
H80CS00293
Additional Details
Current Program Status
Terminated
Registration Date
6/8/2010
Participating Start Date
7/1/2010
Participating Approval Date
6/9/2010
Last Recertification Date
1/30/2019
Termination Date
Termination Reason
7/1/2019
Other
Contacts
Authorizing Official
Gaston Family Health Services
Robert Spencer, CEO
(704) 616-2245
Primary Contact
Gaston Family Health Services, Inc.
Marvin Patrick Allen, Director, Pharmacy Services
(704) 772-4642
Addresses
Street Address
112. S. Oak St.
CHERRYVILLE, NC 28021-3429
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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