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CH042010 ST. JOSEPH'S MERCY CARE SERVICES (Active)
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Main Details
Name
ST. JOSEPH'S MERCY CARE SERVICES
Subdivision Name
Saint Joseph's Mercy Care Services, Inc.
Type
HRSA-Funded Health Center
Site ID
BPS-H80-000834
340B ID
CH042010
Grant Number
H80CS00022
Additional Details
Current Program Status
Active
Registration Date
12/1/1992
Participating Start Date
12/1/1992
Participating Approval Date
6/17/2005
Last Recertification Date
2/19/2025
Contacts
Authorizing Official
Saint Joseph's Mercy Care Services
Pearly Ittickathra, Chief of Care Delivery
(678) 843-8500
Primary Contact
St Joseph's Mercy Care
David P Holland, MD
(675) 884-8889
Addresses
Street Address
424 DECATUR STREET
ATLANTA, GA 30312
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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3/26/05 - ADMIN CORRECTION REPLACES HO042010, 6/17/05 - UPDATED CONTACT
03/30/2009
April 2025
April 2025
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