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FP60617 AUNT MARTHA'S COMUNITY HEALTH CENTER (Active)
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Main Details
Name
AUNT MARTHA'S COMUNITY HEALTH CENTER
Subdivision Name
AUNT MARTHA'S SOUTHEAST SIDE COMUNITY HEALTH CENTER
Type
Family Planning (Title X only)
340B ID
FP60617
Grant Number
FPHPA006459
Additional Details
Current Program Status
Active
Registration Date
1/15/2020
Participating Start Date
4/1/2020
Participating Approval Date
2/3/2020
Last Recertification Date
5/10/2024
Contacts
Authorizing Official
Aunt Martha's
Audrey Pennington, Chief Operating Officer
(708) 747-7100
Primary Contact
Aunt Martha's Health & Wellness
Tamara Lim, VP Quality & Clinical Excellence
(708) 747-7100
Addresses
Street Address
3528 E. 118TH ST
CHICAGO, IL 60617
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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Participating from effective date: (07/01/2010) until terminated effective date: (7/1/2019), reinstatement effective date: (04/01/2020)
01/29/2020
April 2025
April 2025
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