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CH02016J SYRACUSE COMMUNITY HEALTH CENTER, INC. (Terminated)
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Main Details
Name
SYRACUSE COMMUNITY HEALTH CENTER, INC.
Subdivision Name
SCHC SOUTH SITE
Type
HRSA-Funded Health Center
Site ID
BPS-H80-006364
340B ID
CH02016J
Grant Number
H80CS00434
Additional Details
Current Program Status
Terminated
Registration Date
4/11/2017
Participating Start Date
7/1/2017
Participating Approval Date
4/24/2017
Last Recertification Date
3/1/2021
Termination Date
Termination Reason
1/1/2022
Business decision by the Covered Entity
Contacts
Authorizing Official
SCHC
Amy C Ellingworth, CFO
(315) 476-7921 Ext: 2260
Primary Contact
Syracuse Community Health Center
Kerri Devere Warner, Director of Revenue Cycle Management
(315) 476-7921 Ext: 2357
Addresses
Street Address
1701 SOUTH AVE
SYRACUSE, NY 13207-2004
Billing Address
Syracuse Community Health Center
819 South Salina Street
Syracuse, NY 13202
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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