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CH01058T PROVIDENCE COMMUNITY HEALTH CENTERS, INC., THE (Terminated)
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Main Details
Name
PROVIDENCE COMMUNITY HEALTH CENTERS, INC., THE
Subdivision Name
Providence Community Health Centers Annex
Type
HRSA-Funded Health Center
Site ID
BPS-H80-020811
340B ID
CH01058T
Grant Number
H80CS00057
Additional Details
Current Program Status
Terminated
Registration Date
7/5/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/7/2017
Last Recertification Date
2/8/2018
Termination Date
Termination Reason
4/1/2019
Site closure
Contacts
Authorizing Official
PCHC
MERRILL THOMAS, CEO
(401) 444-0400 Ext: 3130
Primary Contact
Providence Community Health Centers
Garrett Clark, CO
(401) 444-0400
Addresses
Street Address
9 Warren Way
Providence, RI 02905
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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