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CH051741J SHALOM HEALTH CARE CENTER, INC. (Active)
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Main Details
Name
SHALOM HEALTH CARE CENTER, INC.
Subdivision Name
Shalom 56th Street - New Access Point
Type
HRSA-Funded Health Center
Site ID
BPS-H80-017386
340B ID
CH051741J
Grant Number
H80CS00880
Additional Details
Current Program Status
Active
Registration Date
4/15/2016
Participating Start Date
7/1/2016
Participating Approval Date
4/25/2016
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Shalom Health Care Center
Leonardo R. Ortega, Executive Director/CEO
(317) 291-7422 Ext: 1105
Primary Contact
Shalom Health Center
Bianca Daisy-Bell, Clinical Pharmacist
(317) 291-7422 Ext: 1422
Addresses
Street Address
5750 West 56th Street
Indianapolis, IN 46254-1695
Billing Address
SHALOM HEALTH CARE CENTER, INC
3400 Lafayette Rd Ste 200
Indianapolis, IN 46222-1147
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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