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CH02056AL Mosaic Health, Inc. (Terminated)
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Main Details
Name
Mosaic Health, Inc.
Subdivision Name
Charlotte School Based Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-016998
340B ID
CH02056AL
Grant Number
H80CS00167
Additional Details
Current Program Status
Terminated
Registration Date
1/4/2016
Participating Start Date
4/1/2016
Participating Approval Date
1/12/2016
Last Recertification Date
2/12/2024
Termination Date
Termination Reason
7/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Mosaic Health, Inc.
Michael Joseph Leary, President/CEO
(585) 325-2280 Ext: 7302
Primary Contact
Mosaic Health, Inc.
Vanessa I. Simmons, Quality Specialist
(585) 325-2280 Ext: 7308
Addresses
Street Address
4115 LAKE AVE
ROCHESTER, NY 14612-4813
Billing Address
Mosaic Health, Inc.
1 S Washington Street
300
Rochester, NY 14614
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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