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CH061068E INNIS COMMUNITY HEALTH CENTER, INC. (Terminated)
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Main Details
Name
INNIS COMMUNITY HEALTH CENTER, INC.
Subdivision Name
MARINGOUIN COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-015419
340B ID
CH061068E
Grant Number
H80CS00855
Additional Details
Current Program Status
Terminated
Registration Date
1/7/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/11/2016
Last Recertification Date
1/31/2024
Termination Date
Termination Reason
4/1/2025
Site closure
Contacts
Authorizing Official
Innis Community Health Center, Inc.
cindy peavy, Executive Director
(225) 235-9627
Primary Contact
Innis Community Health Center, Inc.
Tracy Lyn Hooper, 340B Administrator
(225) 618-5015
Addresses
Street Address
77695 WAGLEY RD
MARINGOUIN, LA 70757-3028
Billing Address
Innis community health centers, inc
6450 la hwy 1
batchelor, LA 70715
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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May 2025
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