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CHC26566-12 JANE PAULEY COMMUNITY HEALTH CENTER, INC. (Terminated)
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Main Details
Name
JANE PAULEY COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Jane Pauley Community Health Center at Madison Avenue
Type
HRSA-Funded Health Center
Site ID
BPS-H80-017046
340B ID
CHC26566-12
Grant Number
H80CS26566
Additional Details
Current Program Status
Terminated
Registration Date
1/13/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/11/2016
Last Recertification Date
2/13/2018
Termination Date
Termination Reason
1/1/2019
Site closure
Contacts
Authorizing Official
Jane Pauley Community Health Center
Dale Marion, 340B Program Manager
(317) 552-0690
Primary Contact
Jane Pauley Community Health Center
Amanda Boyle, Executive Administrator
(317) 934-0755
Addresses
Street Address
8320 Madison Avenue
Indianapolis, IN 46227-6066
Billing Address
The Jane Pauley Community Health Center
1503 N Mitthoeffer Rd
Indianapolis, IN 46229
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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