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CH05291G FAMILY MEDICAL CENTER OF MICHIGAN INC (Terminated)
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Main Details
Name
FAMILY MEDICAL CENTER OF MICHIGAN INC
Subdivision Name
Family Medical Center of MI - Monroe II
Type
HRSA-Funded Health Center
Site ID
BPS-H80-017487
340B ID
CH05291G
Grant Number
H80CS00390
Additional Details
Current Program Status
Terminated
Registration Date
7/7/2016
Participating Start Date
10/1/2016
Participating Approval Date
7/21/2016
Last Recertification Date
2/12/2020
Termination Date
Termination Reason
4/1/2021
Failure to recertify
Contacts
Authorizing Official
Family Medical Center of Michigan
Chris Croley, C.F.O.
(734) 847-3802 Ext: 1434
Primary Contact
Family Medical Center of Michigan, Inc.
ED LARKINS, CEO
(734) 847-3802 Ext: 1412
Addresses
Street Address
1085 N Macomb ST.
Monroe, MI 48162
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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