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CH072110B Charles Drew Health Center Inc (Terminated)
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Main Details
Name
Charles Drew Health Center Inc
Subdivision Name
Benson Community Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-008208
340B ID
CH072110B
Grant Number
H80CS00438
Additional Details
Current Program Status
Terminated
Registration Date
4/4/2013
Participating Start Date
7/1/2013
Participating Approval Date
5/22/2013
Last Recertification Date
3/7/2016
Termination Date
Termination Reason
4/1/2016
Site closure
Contacts
Authorizing Official
Kenny Mcmorris, CEO
(402) 457-1245
Primary Contact
Timothy J. Bourke, Director of Pharmacy
(402) 451-3244
Addresses
Street Address
5420 North West Radial Highway
Omaha, NE 68104
Billing Address
Charles Drew Health Center Inc.
2915 Grant St
Omaha, NE 68111
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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