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CHC26564-02 SOUTH CENTRAL MISSOURI COMMUNITY HEALTH CENTER (Terminated)
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Main Details
Name
SOUTH CENTRAL MISSOURI COMMUNITY HEALTH CENTER
Subdivision Name
Your Community Health Center at PCHD
Type
HRSA-Funded Health Center
Site ID
BPS-H80-017507
340B ID
CHC26564-02
Grant Number
H80CS26564
Additional Details
Current Program Status
Terminated
Registration Date
7/11/2016
Participating Start Date
10/1/2016
Participating Approval Date
7/15/2016
Last Recertification Date
2/13/2017
Termination Date
Termination Reason
4/1/2018
Business decision by the Covered Entity
Contacts
Authorizing Official
South Central Missouri Community Health Center dba Your Community Health Center
Kelly Miller, Interim CEO/CFO
(573) 426-6714
Primary Contact
Your Community Health Center
Angela Brooks, RPH
(573) 242-6311
Addresses
Street Address
200 North Main Street
Rolla, MO 65401-6540
Billing Address
Your Community Health Center
1516 Bridge School Road
Rolla, MO 65401
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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