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CH05744L PCC COMMUNITY WELLNESS CENTER (Terminated)
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Main Details
Name
PCC COMMUNITY WELLNESS CENTER
Subdivision Name
PCC Community Wellness Center at West Suburban
Type
HRSA-Funded Health Center
Site ID
BPS-H80-021231
340B ID
CH05744L
Grant Number
H80CS00276
Additional Details
Current Program Status
Terminated
Registration Date
4/1/2014
Participating Start Date
7/1/2014
Participating Approval Date
4/9/2014
Last Recertification Date
2/3/2021
Termination Date
Termination Reason
7/1/2021
Site closure
Contacts
Authorizing Official
PCC Community Wellness Center
Robert Urso, President & CEO
(708) 524-7686
Primary Contact
PCC Community Wellness Center
Patrick R Garrick, Chief Financial Officer
(708) 383-0113 Ext: 7340
Addresses
Street Address
1 Erie Court
Suite 7140
Oak Park, IL 60302-2510
Billing Address
PCC Community Wellness Center
14 Lake Street
Oak Park, IL 60302
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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