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CH05102C HACKLEY COMMUNITY CARE CENTER INC (Terminated)
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Main Details
Name
HACKLEY COMMUNITY CARE CENTER INC
Subdivision Name
Hackley Community Care Center Leahy Site
Type
HRSA-Funded Health Center
Site ID
BPS-H80-012610
340B ID
CH05102C
Grant Number
H80CS00684
Additional Details
Current Program Status
Terminated
Registration Date
1/7/2015
Participating Start Date
4/1/2015
Participating Approval Date
1/12/2015
Last Recertification Date
2/16/2024
Termination Date
Termination Reason
4/1/2025
Site closure
Contacts
Authorizing Official
Hackley Community Care Center
Valerie J Blondin, CFO
(231) 733-6657
Primary Contact
Hackley Community Care Center, Inc
Troy McLouth, Pharmacy Manager
(231) 733-6665
Addresses
Street Address
1675 Leahy St.
Muskegon, MI 49442-5500
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
April 2025
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