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CH04033T Jessie Trice Community Health System, Inc. (Terminated)
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Main Details
Name
Jessie Trice Community Health System, Inc.
Subdivision Name
Jessie Trice Community Health System - Miami Gardens
Type
HRSA-Funded Health Center
Site ID
BPS-H80-012845
340B ID
CH04033T
Grant Number
H80CS00732
Additional Details
Current Program Status
Terminated
Registration Date
1/14/2014
Participating Start Date
4/1/2014
Participating Approval Date
2/25/2014
Last Recertification Date
2/6/2021
Termination Date
Termination Reason
1/1/2022
Business decision by the Covered Entity
Contacts
Authorizing Official
Jessie Trice Community Health Center, Inc
Annie Neasman, President & CEO
(305) 805-1700 Ext: 1000
Primary Contact
JESSIE TRICE COMMUNITY HEALTH SYSTEM
Ruth Duval, Executive VP & Chief Nursing Officer
(305) 805-1700 Ext: 1011
Addresses
Street Address
4692 NW 183rd Street
Miami Gardens, FL 33055-3054
Billing Address
Jessie Trice Community Health System
5607 NW 27th Ave
Miami, FL 33142
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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