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CHC26576-01 Five Rivers Health Centers (Terminated)
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Main Details
Name
Five Rivers Health Centers
Subdivision Name
Five Rivers Medical Surgical Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-013244
340B ID
CHC26576-01
Grant Number
H80CS26576
Additional Details
Current Program Status
Terminated
Registration Date
7/11/2014
Participating Start Date
10/1/2014
Participating Approval Date
7/22/2014
Last Recertification Date
2/9/2022
Termination Date
Termination Reason
1/1/2023
Site closure
Contacts
Authorizing Official
Five Rivers Health Centers
Diane M. Cummins, Chief Operating Officer
(937) 281-5942
Primary Contact
Five Rivers Health Centers
John Howard Tomlin, Pharmacy Director
(937) 281-6825
Addresses
Street Address
725 South Ludlow
Dayton, OH 45402
Billing Address
Five Rivers Health Centers
2261 Philadelphia Dr.
Dayton, OH 45406
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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