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CH05321CK ERIE FAMILY HEALTH CENTER, INC. (Active)
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Main Details
Name
ERIE FAMILY HEALTH CENTER, INC.
Subdivision Name
Erie Lake View School Based Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-010649
340B ID
CH05321CK
Grant Number
H80CS00115
Additional Details
Current Program Status
Active
Registration Date
8/16/2012
Participating Start Date
10/1/2012
Participating Approval Date
8/30/2012
Last Recertification Date
2/23/2025
Contacts
Authorizing Official
Erie Family Health Centers
David Bruce, Chief Financial & Administrative Officer (CFAO)
(312) 432-2725
Primary Contact
ERIE FAMILY HEALTH CENTER, INC.
Shawn Trewartha, Pharmacy Business Data Analyst
(312) 432-7506
Addresses
Street Address
4015 N Ashland Ave
Chicago, IL 60613
Billing Address
ERIE FAMILY HEALTH CENTER, INC.
1701 W Superior St
Chicago, IL 60622
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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