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CHC26514-08 TRIAD ADULT AND PEDIATRIC MEDICINE, INC. (Terminated)
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Main Details
Name
TRIAD ADULT AND PEDIATRIC MEDICINE, INC.
Subdivision Name
TAPM Family Medicine at East Market Street
Type
HRSA-Funded Health Center
Site ID
BPS-H80-015762
340B ID
CHC26514-08
Grant Number
H80CS26514
Additional Details
Current Program Status
Terminated
Registration Date
10/11/2016
Participating Start Date
1/1/2017
Participating Approval Date
11/17/2016
Last Recertification Date
1/29/2019
Termination Date
Termination Reason
1/1/2020
Site closure
Contacts
Authorizing Official
Triad Adult and Pediatric Medicine
Danielle Cole, Finance Director
(336) 355-9728
Primary Contact
Triad Adult and Pediatric Medicine
Michelle Lewis, CEO
(336) 355-9715
Addresses
Street Address
1102 E MARKET ST
GREENSBORO, NC 27401-6056
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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May 2025
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