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RWI28215 EASTOWNE FAMILY PHYSICIANS, PA (Terminated)
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Main Details
Name
EASTOWNE FAMILY PHYSICIANS, PA
Subdivision Name
Type
Ryan White Part A
340B ID
RWI28215
Grant Number
CHARLOTTE TGA
Additional Details
Current Program Status
Terminated
Registration Date
6/15/2010
Participating Start Date
7/1/2010
Participating Approval Date
6/16/2010
Last Recertification Date
2/7/2018
Time Period the Assistance was Received
Termination Date
Termination Reason
4/1/2019
Loss of qualifying grant/support
Contacts
Authorizing Official
Eastowne Family Physicians
Tagbo Ekwonu, Medical Director
(704) 532-4567
Primary Contact
Eastowne Family Physicians
Amaka Ekwonu, Office Manager
(704) 532-4567
Addresses
Street Address
4115 The Plaza
CHARLOTTE, NC 28205
Billing Address
Eastowne Family Physicians, PA
P.O. Box 1280
Matthews, NC 28106
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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