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CH10248F COWLITZ FAMILY HEALTH CENTER (Active)
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Main Details
Name
COWLITZ FAMILY HEALTH CENTER
Subdivision Name
FHC Kelso Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-012656
340B ID
CH10248F
Grant Number
H80CS00542
Additional Details
Current Program Status
Active
Registration Date
7/7/2014
Participating Start Date
10/1/2014
Participating Approval Date
7/22/2014
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
Cowlitz Family Health Center
JIm Coffee, CEO
(360) 636-3892
Primary Contact
Cowlitz Family Health Center
Jim Merrill, CFO
(360) 636-3892
Addresses
Street Address
300 Oak Street STE B
Kelso, WA 98626-2304
Billing Address
Cowlitz Family Health Center
1057 12th Avenue
Longview, WA 98632
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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