340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CHC26568-00 SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER (Terminated)
Print
Main Details
Name
SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER
Subdivision Name
Regional Health Clinic, Homeless Site
Type
HRSA-Funded Health Center
Site ID
BPS-H80-013114
340B ID
CHC26568-00
Grant Number
H80CS26568
Additional Details
Current Program Status
Terminated
Registration Date
1/3/2014
Participating Start Date
4/1/2014
Participating Approval Date
2/26/2014
Last Recertification Date
2/7/2024
Termination Date
Termination Reason
4/1/2025
Business decision by the Covered Entity
Contacts
Authorizing Official
Southlake Community Mental Health Center, Inc
Amy Lopez, Executive Director
(219) 671-6047
Primary Contact
SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER
Lori Bugielski, Pharmacy Tech/analyst
(219) 840-2694
Addresses
Street Address
527 State St
Hammond, IN 46320-1533
Billing Address
Regional Health Clinic
559 State Street
Hammond, IN 46320-1533
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
April 2025
April 2025
week
S
M
T
W
T
F
S
14
30
31
1
2
3
4
5
15
6
7
8
9
10
11
12
16
13
14
15
16
17
18
19
17
20
21
22
23
24
25
26
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session