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CH04100F WAKE HEALTH SERVICES, INC. d/b/a Advance Community Health (Terminated)
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Main Details
Name
WAKE HEALTH SERVICES, INC. d/b/a Advance Community Health
Subdivision Name
Horizon at South Wilmington
Type
HRSA-Funded Health Center
Site ID
BPS-H80-006858
340B ID
CH04100F
Grant Number
H80CS00087
Additional Details
Current Program Status
Terminated
Registration Date
4/8/2013
Participating Start Date
7/1/2013
Participating Approval Date
5/10/2013
Last Recertification Date
1/30/2019
Termination Date
Termination Reason
10/1/2019
Business decision by the Covered Entity
Contacts
Authorizing Official
Wake Health Services d/b/a Advance Community Health
Penella M. Washington, CEO
(919) 250-2923
Primary Contact
Wake Health Services
Carla May, RPH
(919) 573-4706
Addresses
Street Address
1420 S Wilmington St
Raleigh, NC 27603-2526
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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