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CHC28344-04 BANYAN COMMUNITY HEALTH CENTER, INC. (Terminated)
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Main Details
Name
BANYAN COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Banyan Community Health Center - LeJeune
Type
HRSA-Funded Health Center
Site ID
BPS-H80-019082
340B ID
CHC28344-04
Grant Number
H80CS28344
Additional Details
Current Program Status
Terminated
Registration Date
7/5/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/13/2017
Last Recertification Date
2/6/2019
Termination Date
Termination Reason
4/1/2020
Site closure
Contacts
Authorizing Official
Banyan Community Health Center
Ileana Ruiz Garcia, Executive DIrector
(305) 398-6132
Primary Contact
Banyan Community Health Center
Emy Lou Sirota, QI Director
(305) 398-6197
Addresses
Street Address
10 NW 42nd Avenue Fifth Floor
Miami, FL 33126-5473
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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