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CH05744N PCC COMMUNITY WELLNESS CENTER (Terminated)
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Main Details
Name
PCC COMMUNITY WELLNESS CENTER
Subdivision Name
PCC Walk-In Wellness Center at West Suburban Medical Center Suite 7040
Type
HRSA-Funded Health Center
Site ID
BPS-H80-018944
340B ID
CH05744N
Grant Number
H80CS00276
Additional Details
Current Program Status
Terminated
Registration Date
1/17/2017
Participating Start Date
4/1/2017
Participating Approval Date
2/2/2017
Last Recertification Date
Termination Date
Termination Reason
1/1/2018
Site closure
Contacts
Authorizing Official
PCC Community Wellness Center
Robert Urso, President & CEO
(708) 524-7686
Primary Contact
PCC Community Wellness Center
Lynn Hopkins, Chief Operating Officer
(708) 524-7678
Addresses
Street Address
1 Erie Court, Suite 7040
Oak Park, IL 60302-2510
Billing Address
PCC Community Wellness Center
14 Lake Street
Oak Park, IL 60302
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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