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CH04479C PRIMARY HEALTH CARE CENTER OF DADE, INC. (Terminated)
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Main Details
Name
PRIMARY HEALTH CARE CENTER OF DADE, INC.
Subdivision Name
Primary Health Care Center Cedartown
Type
HRSA-Funded Health Center
Site ID
BPS-H80-012906
340B ID
CH04479C
Grant Number
H80CS00649
Additional Details
Current Program Status
Terminated
Registration Date
7/3/2014
Participating Start Date
10/1/2014
Participating Approval Date
7/23/2014
Last Recertification Date
2/9/2024
Termination Date
Termination Reason
7/1/2024
Site closure
Contacts
Authorizing Official
Primary Health Care Center of Dade, Inc.
DIANA U. ALLEN, CEO
(706) 620-4494 Ext: 8549
Primary Contact
Primary Health Care Center of Dade, Inc.
Melanie Forsythe, COO
(706) 620-4494 Ext: 8541
Addresses
Street Address
118 E GIRARD AVE
CEDARTOWN, GA 30125-2778
Billing Address
Primary Health Care Center of Dade, Inc.
100 Mitchell Road
Fort Oglethorpe, GA 30742
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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