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CH057260B KENOSHA COMMUNITY HEALTH CENTER INC (Active)
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Main Details
Name
KENOSHA COMMUNITY HEALTH CENTER INC
Subdivision Name
Kenosha Community Health Center, Inc.
Type
HRSA-Funded Health Center
Site ID
BPS-H80-007585
340B ID
CH057260B
Grant Number
H80CS00662
Additional Details
Current Program Status
Active
Registration Date
7/2/2013
Participating Start Date
10/1/2013
Participating Approval Date
8/20/2013
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Kenosha Community Health Center, Inc.
John Stampfl, Controller
(262) 771-3561
Primary Contact
Kenosha Community Health Center, Inc.
Mark P. Celebre, Director of Pharmacy
(262) 771-1920
Addresses
Street Address
6226 14th Avenue
Kenosha, WI 53143
Billing Address
Kenosha Community Health Center
4006 Washington Road
Kenosha, WI 53144
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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February 2025
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