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CH02056AN Mosaic Health, Inc. (Terminated)
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Main Details
Name
Mosaic Health, Inc.
Subdivision Name
Newark Internal Medicine
Type
HRSA-Funded Health Center
Site ID
BPS-H80-018845
340B ID
CH02056AN
Grant Number
H80CS00167
Additional Details
Current Program Status
Terminated
Registration Date
1/17/2017
Participating Start Date
4/1/2017
Participating Approval Date
2/16/2017
Last Recertification Date
2/12/2024
Termination Date
Termination Reason
7/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Mosaic Health, Inc.
Michael Joseph Leary, President/CEO
(585) 325-2280 Ext: 7302
Primary Contact
Mosaic Health, Inc.
Vanessa I. Simmons, Quality Specialist
(585) 325-2280 Ext: 7308
Addresses
Street Address
1208 Driving Park Ave
Newark, NY 14513
Billing Address
Mosaic Health
1 S Washington Street
Suite 300
Rochester, NY 14614
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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