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CH04243L THE COASTAL FAMILY HEALTH CENTER INC (Terminated)
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Main Details
Name
THE COASTAL FAMILY HEALTH CENTER INC
Subdivision Name
GULFPORT II HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-008816
340B ID
CH04243L
Grant Number
H80CS00188
Additional Details
Current Program Status
Terminated
Registration Date
4/1/2015
Participating Start Date
7/1/2015
Participating Approval Date
4/14/2015
Last Recertification Date
2/12/2016
Termination Date
Termination Reason
4/1/2016
Site closure
Contacts
Authorizing Official
Coastal Family Health Center
ANGEL GREER, CEO
(228) 374-2494 Ext: 1133
Primary Contact
Coastal Family Health Center
Larry J. Knight, COO
(228) 374-2494 Ext: 1116
Addresses
Street Address
1408 44th Ave
Gulfport, MS 39501-2554
Billing Address
Coastal Family Health Center
PO Box 475
Biloxi, MS 39533
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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