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CH051278N Tapestry 360 Health (Terminated)
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Main Details
Name
Tapestry 360 Health
Subdivision Name
Tapestry 360 Health - C4 - Broadway
Type
HRSA-Funded Health Center
Site ID
BPS-H80-012378
340B ID
CH051278N
Grant Number
H80CS00215
Additional Details
Current Program Status
Terminated
Registration Date
4/2/2015
Participating Start Date
7/1/2015
Participating Approval Date
4/14/2015
Last Recertification Date
1/31/2024
Termination Date
Termination Reason
4/1/2025
Business decision by the Covered Entity
Contacts
Authorizing Official
Tapestry 360 Health
Nicole Willis, CEO
(773) 296-7589
Primary Contact
Tapestry 360 Health
Marquitta Moore, Director, Operations
(872) 249-9333
Addresses
Street Address
5710 N Broadway St
Chicago, IL 60660-4302
Billing Address
Tapestry 360 Health
1301 W Devon
Chicago, IL 60660
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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