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CH05744J PCC COMMUNITY WELLNESS CENTER (Terminated)
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Main Details
Name
PCC COMMUNITY WELLNESS CENTER
Subdivision Name
PCC Walk-In Wellness Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-008587
340B ID
CH05744J
Grant Number
H80CS00276
Additional Details
Current Program Status
Terminated
Registration Date
6/22/2012
Participating Start Date
10/1/2012
Participating Approval Date
8/30/2012
Last Recertification Date
1/27/2017
Termination Date
Termination Reason
1/1/2018
Site closure
Contacts
Authorizing Official
PCC Community Wellness Center
Robert Urso, President & CEO
(708) 524-7686
Primary Contact
PCC Community Wellness Center
Lynn Hopkins, Chief Operating Officer
(708) 524-7678
Addresses
Street Address
1044 N. Francisco Ave.
Chicago, IL 60622-2743
Billing Address
PCC Community Wellness Center
14 Lake Street
Oak Park, IL 60302-2606
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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