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CH02056AB Mosaic Health, Inc. (Terminated)
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Main Details
Name
Mosaic Health, Inc.
Subdivision Name
Martin Luther King Jr Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-003017
340B ID
CH02056AB
Grant Number
H80CS00167
Additional Details
Current Program Status
Terminated
Registration Date
8/31/2012
Participating Start Date
10/1/2012
Participating Approval Date
9/10/2012
Last Recertification Date
2/12/2024
Termination Date
Termination Reason
7/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Mosaic Health, Inc.
Michael Joseph Leary, President/CEO
(585) 325-2280 Ext: 7302
Primary Contact
Mosaic Health, Inc.
Vanessa I. Simmons, Quality Specialist
(585) 325-2280 Ext: 7308
Addresses
Street Address
485 Clinton Ave N
Rochester, NY 14605-1817
Billing Address
Mosaic Health, Inc.
1 S. Washington St
Suite 300
Rochester, NY 14614-3632
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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