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CH05022K INTERCARE COMMUNITY HEALTH NETWORK (Active)
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Main Details
Name
INTERCARE COMMUNITY HEALTH NETWORK
Subdivision Name
INTERCARE MEDICAL VAN
Type
HRSA-Funded Health Center
Site ID
BPS-H80-006462
340B ID
CH05022K
Grant Number
H80CS00771
Additional Details
Current Program Status
Active
Registration Date
4/1/2014
Participating Start Date
7/1/2014
Participating Approval Date
4/11/2014
Last Recertification Date
2/17/2025
Contacts
Authorizing Official
InterCare Community Health Network
VELMA HENDERSHOTT, CEO
(269) 427-7937 Ext: 200
Primary Contact
InterCare Community Health Network
John McElwee, Chief Financial Office
(269) 427-7937
Addresses
Street Address
308 CHARLES ST STE P
BANGOR, MI 49013-1317
Billing Address
INTERCARE COMMUNITY HEALTH NETWORK
50 INDUSTRIAL PARK RD
Bangor, MI 49013-1246
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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