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CHC26592-01 COASTAL COMMUNITY HEALTH SERVICES, INC. (Terminated)
Main Details
Name
COASTAL COMMUNITY HEALTH SERVICES, INC.
Subdivision Name
Perry Park
Type
HRSA-Funded Health Center
Site ID
BPS-H80-018961
340B ID
CHC26592-01
Grant Number
H80CS26592
Contacts
Authorizing Official
Coastal Community Health Services
Kavanaugh Chandler, CEO
(912) 275-8028 Ext: 1139
Primary Contact
Coastal Community Health Services, Inc.
Martina Senol, CFO
(912) 275-8028 Ext: 111
Additional Details
Current Program Status
Terminated
Registration Date
4/14/2017
Participating Start Date
7/1/2017
Participating Approval Date
4/24/2017
Last Recertification Date
1/31/2022
Termination Date
1/1/2023
Termination Reason
Site closure
Addresses
Street Address
2211 Bartow Street
Brunswick, GA 31520-5604
Billing Address
Coastal Community Health Services, INC.
106 Shoppers Way
Suite 1
Brunswick, GA 31525
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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