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CH051516AF GREATER ELGIN FAMILY CARE CENTER (Terminated)
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Main Details
Name
GREATER ELGIN FAMILY CARE CENTER
Subdivision Name
Lakewood School
Type
HRSA-Funded Health Center
Site ID
BPS-H80-014648
340B ID
CH051516AF
Grant Number
H80CS00288
Additional Details
Current Program Status
Terminated
Registration Date
10/13/2015
Participating Start Date
1/1/2016
Participating Approval Date
10/20/2015
Last Recertification Date
2/21/2017
Termination Date
Termination Reason
4/1/2018
Business decision by the Covered Entity
Contacts
Authorizing Official
Greater Family Health
ROBERT M. TANNER, PRESIDENT/CEO
(847) 608-1344 Ext: 230
Primary Contact
Greater Family Health
ROBERT M. TANNER, PRESIDENT/CEO
(847) 608-1344 Ext: 230
Addresses
Street Address
1651 RAVINE LN
CARPENTERSVILLE, IL 60110-2130
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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