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CHC12871-00 GREATER PRINCE WILLIAM COMMUNITY HEALTH CENTER, INC. (Terminated)
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Main Details
Name
GREATER PRINCE WILLIAM COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Ridgewood
Type
HRSA-Funded Health Center
Site ID
BPS-H80-008255
340B ID
CHC12871-00
Grant Number
H80CS12871
Additional Details
Current Program Status
Terminated
Registration Date
8/31/2010
Participating Start Date
10/1/2010
Participating Approval Date
9/1/2010
Last Recertification Date
2/3/2023
Termination Date
Termination Reason
4/1/2024
Site closure
Contacts
Authorizing Official
Greater Prince William Community Health Center
Mark Meye, Chief Executive Director
(703) 680-6524
Primary Contact
Greater Prince William Community Health Center
Hunter Peterson, Chief Compliance Officer
(703) 680-7950 Ext: 3999
Addresses
Street Address
4379 Ridgewood Center Dr., Suite 102
Woodbridge, VA 22192
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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