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CHC26514-04 TRIAD ADULT AND PEDIATRIC MEDICINE, INC. (Terminated)
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Main Details
Name
TRIAD ADULT AND PEDIATRIC MEDICINE, INC.
Subdivision Name
High Point Adult Medicine
Type
HRSA-Funded Health Center
Site ID
BPS-H80-012923
340B ID
CHC26514-04
Grant Number
H80CS26514
Additional Details
Current Program Status
Terminated
Registration Date
10/2/2014
Participating Start Date
1/1/2015
Participating Approval Date
10/9/2014
Last Recertification Date
2/26/2016
Termination Date
Termination Reason
4/1/2016
Site closure
Contacts
Authorizing Official
Brian Ellerby, CEO
(336) 355-9697
Primary Contact
Amy Hallisey, Pharmacy Director
(336) 355-9908
Addresses
Street Address
624 Quaker Lane STE 100-C
High Point, NC 27262
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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June 2025
June 2025
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