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CHC12890-04 FAIRFIELD COMMUNITY HEALTH CENTER (Terminated)
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Main Details
Name
FAIRFIELD COMMUNITY HEALTH CENTER
Subdivision Name
Fairfield Community Health Center - Baltimore
Type
HRSA-Funded Health Center
Site ID
BPS-H80-010831
340B ID
CHC12890-04
Grant Number
H80CS19595
Additional Details
Current Program Status
Terminated
Registration Date
9/19/2011
Participating Start Date
1/1/2012
Participating Approval Date
11/28/2011
Last Recertification Date
1/30/2023
Termination Date
Termination Reason
10/1/2023
Site closure
Contacts
Authorizing Official
FAIRFIELD COMMUNITY HEALTH CENTER
Kim Rase-Shuttleworth, Revenue Specialist
(740) 277-6043 Ext: 1011
Primary Contact
Fairfield Community Health Center
Daniel Edward Fisher, CFO
(740) 277-6043 Ext: 1002
Addresses
Street Address
1055 W Market St STE H
Baltimore, OH 43105-1284
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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