340B Drug Pricing Program Database
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CH08380H MIDTOWN COMMUNITY HEALTH CENTER, INC. (Terminated)
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Main Details
Name
MIDTOWN COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Midtown Community Health Center Logan Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-027010
340B ID
CH08380H
Grant Number
H80CS00831
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/10/2016
Last Recertification Date
1/31/2023
Termination Date
Termination Reason
4/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Midtown Community Health Center
Alicia Martinez, Chief Executive Officer
(801) 334-1321
Primary Contact
Midtown Community Health Center
Braden D. Mitchell, Pharmacy Director
(801) 395-8200
Addresses
Street Address
550 East 1400 North
Logan, UT 84341
Billing Address
Midtown Community Health Center
2240 Adams Avenue
Ogden, UT 84401
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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