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CH032240 PENINSULA INSTITUTE FOR COMMUNITY HEALTH (PICH) (Active)
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Main Details
Name
PENINSULA INSTITUTE FOR COMMUNITY HEALTH (PICH)
Subdivision Name
DBA 48TH STREET PHYSICIANS
Type
HRSA-Funded Health Center
Site ID
BPS-H80-007792
340B ID
CH032240
Grant Number
H80CS00073
Additional Details
Current Program Status
Active
Registration Date
12/1/1992
Participating Start Date
12/1/1992
Participating Approval Date
12/2/2004
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Peninsula Institue for Community Health
ANGELA FUTRELL, CEO
(757) 591-0643 Ext: 1120
Primary Contact
Peninsula Institute for Community Health
VALDA BRANCH, COO
(757) 223-7007
Addresses
Street Address
4714 MARSHALL AVENUE
NEWPORT NEWS, VA 23607-2247
Billing Address
PENINSULA INSTITUTE FOR COMMUNITY HEALTH (PICH)
1033-28TH STREET, 2ND FLOOR
NEWPORT NEWS, VA 23607-2247
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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9/24/09 SHIP TO REMOVED (WAS PHARMACY CARE OF HAMPTON ROADS 1033-28TH STREET, 2ND FLOOR)11/23/04 - NEW CONTACT INFO - THIS RECORD COMBINES INFO FROM HO032240; 12/2/04 - NEW SHIP TO/BILL TO, MODIFIED ENTITY NAME
09/24/2009
May 2025
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