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FP026015 HYANNIS FAMILY PLANNING (Terminated)
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Main Details
Name
HYANNIS FAMILY PLANNING
Subdivision Name
Type
Family Planning (Title X only)
340B ID
FP026015
Grant Number
FPHPA016029
Additional Details
Current Program Status
Terminated
Registration Date
1/1/1998
Participating Start Date
1/1/1998
Participating Approval Date
1/1/1998
Last Recertification Date
5/28/2019
Termination Date
Termination Reason
10/1/2019
Change of covered entity type (non-hospital)
Contacts
Authorizing Official
Health Imperatives
Emily Gold, Director of Reproductive Health Services
(508) 274-6541
Primary Contact
Health Imperatives
Jessica Cisternelli, Director of Operations
(508) 367-1963
Addresses
Street Address
1019 IYANOUGH RD
HYANNIS, MA 02601
Billing Address
HEALTH IMPERATIVES, INC
942 W. CHESTNUT ST.
BROCKTON, MA 02301
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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2/14/12 Added NPI # 1,2; 2/2/10 UPDATED SHIP TO (WAS HEALTH CARE OF SE MA); 2/2/10 UPDATED BILL TO (WAS HEALTH CARE OF SE MA); 3/12/06 ADDED BILL TO; 3/12/06 ADDED SHIP TO;
02/14/2012
2/2/10 UPDATED SHIP TO (WAS HEALTH CARE OF SE MA); 2/2/10 UPDATED BILL TO (WAS HEALTH CARE OF SE MA); 3/12/06 ADDED BILL TO; 3/12/06 ADDED SHIP TO;
02/02/2010
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