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CH06235D IBERIA COMPRHESIVE COM HEALTH CNTR, INC. (Active)
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Main Details
Name
IBERIA COMPRHESIVE COM HEALTH CNTR, INC.
Subdivision Name
Surrey Street Community Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-011068
340B ID
CH06235D
Grant Number
H80CS00697
Additional Details
Current Program Status
Active
Registration Date
1/11/2013
Participating Start Date
4/1/2013
Participating Approval Date
2/20/2013
Last Recertification Date
2/18/2025
Contacts
Authorizing Official
Iberia Comprehensive Community Health Center, Inc.
De'Marquis Hamilton, CEO
(337) 365-4945 Ext: 1210
Primary Contact
Iberia Comprehensive Community Health Center, Inc.
Reginald Boutte, Pharmacist In Charge
(337) 365-4945 Ext: 146
Addresses
Street Address
1004 Surrey St
Lafayette, LA 70501-6143
Billing Address
Iberia Comprehensive Community Health Center, Inc.
806 Jefferson Terrace Blvd
New Iberia, LA 70560-5727
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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