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CH010830 EDWARD M. KENNEDY COMMUNITY HEALTH CENTER (Active)
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Main Details
Name
EDWARD M. KENNEDY COMMUNITY HEALTH CENTER
Subdivision Name
EDWARD M. KENNEDY COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-004221
340B ID
CH010830
Grant Number
H80CS00465
Additional Details
Current Program Status
Active
Registration Date
12/1/1992
Participating Start Date
12/1/1992
Participating Approval Date
1/21/2005
Last Recertification Date
3/5/2025
Contacts
Authorizing Official
Edward M. Kennedy Community Health Center
Stephen J. Kerrigan, President and CEO
(508) 854-2122 Ext: 5085327311
Primary Contact
Edward M. Kennedy Community Health Center
Roberlyne Pezanetti, COO
(508) 270-5751
Addresses
Street Address
19 Tacoma St
Worcester, MA 01605-3516
Billing Address
EDWARD M. KENNEDY COMMUNITY HEALTH CENTER, INC.
115 Northeast Cutoff
Building 2; Suite 200
Worcester, MA 01606
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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2/8/11 UPDATED ENTITY NAME (WAS GREAT BROOK VALLEY HEAL); 8/26/10 ADDED BILL TO; 1/21/05 - UPDATED CONTACT INFO, THIS RECORD NOW COMBINES INFO WITH PH010830
02/09/2011
May 2025
May 2025
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