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RWI07102 Saint Michael's Clinics, Inc. (Active)
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Main Details
Name
Saint Michael's Clinics, Inc.
Subdivision Name
Peter Ho Memorial Clinic
Type
Ryan White Part A
340B ID
RWI07102
Grant Number
H89HA00003
Additional Details
Current Program Status
Active
Registration Date
4/1/2016
Participating Start Date
7/1/2016
Participating Approval Date
6/6/2016
Last Recertification Date
2/11/2025
Time Period the Assistance was Received
3/1/2024 - 2/28/2026
Contacts
Authorizing Official
Saint Michael's Medical Center
Alan Sickles, CEO
(973) 877-5549
Primary Contact
Saint Michael's Clinics Inc
Mark Brown, Peter Ho Clinic manager
(973) 877-2324
Addresses
Street Address
111 Central Ave
Newark, NJ 07102
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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