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FQHCLA330 BOND COMMUNITY HEALTH CENTER INC (Terminated)
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Main Details
Name
BOND COMMUNITY HEALTH CENTER INC
Subdivision Name
Bond Community Health Center (Main Site)
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-014296
340B ID
FQHCLA330
Grant Number
LALCS00163
Additional Details
Current Program Status
Terminated
Registration Date
10/10/2014
Participating Start Date
1/1/2015
Participating Approval Date
10/24/2014
Last Recertification Date
2/10/2015
Termination Date
Termination Reason
1/1/2016
Change of covered entity type
Contacts
Authorizing Official
Bond
Temple O. Robinson, CEO
(850) 576-4073 Ext: 207
Primary Contact
Bond Community Health Center
Margrette Fortune, Pharmacy Director
(850) 521-5112 Ext: 266
Addresses
Street Address
1720 S. Gadsden Street
Tallahassee, FL 32301-5506
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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