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CH02207F ANTHONY L JORDAN HEALTH CORP (Terminated)
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Main Details
Name
ANTHONY L JORDAN HEALTH CORP
Subdivision Name
Jordan Health at Andrews Terrace
Type
HRSA-Funded Health Center
Site ID
BPS-H80-010724
340B ID
CH02207F
Grant Number
H80CS21582
Additional Details
Current Program Status
Terminated
Registration Date
4/14/2012
Participating Start Date
7/1/2012
Participating Approval Date
6/19/2012
Last Recertification Date
2/18/2019
Termination Date
Termination Reason
10/1/2019
Site closure
Contacts
Authorizing Official
Jordan Health
Jonathan Clune, CFO
(585) 423-2813
Primary Contact
Anthony L. Jordan Health Corp.
Kevin Scott Sutherland, Director of Finance and Grants Administration
(585) 423-2871
Addresses
Street Address
125 Saint Paul St
Rochester, NY 14604-1203
Billing Address
Anthony L. Jordan Health Center
82 Holland Street
Rochester, NY 14605-2131
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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5/16/12 - Reviewed registration and forwarded to IS.
05/16/2012
May 2025
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