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CH071927A CRESCENT COMMUNITY HEALTH CENTER (Terminated)
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Main Details
Name
CRESCENT COMMUNITY HEALTH CENTER
Subdivision Name
Stonehill Dental Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-018077
340B ID
CH071927A
Grant Number
H80CS08765
Additional Details
Current Program Status
Terminated
Registration Date
10/13/2016
Participating Start Date
1/1/2017
Participating Approval Date
10/24/2016
Last Recertification Date
2/1/2019
Termination Date
Termination Reason
1/1/2020
Business decision by the Covered Entity
Contacts
Authorizing Official
Crescent Community Health Center
Brooke Gomez, COO, Interim CEO
(563) 690-2873
Primary Contact
Crescent Community Health Center
Heather Marcelle Rickertsen, Director of Clinical Pharmacy Services
(563) 690-2433
Addresses
Street Address
3475 Windsor Ave.
Dubuque, IA 52001
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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