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CHC28356-00 MARILLAC CLINIC, INC. (Active)
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Main Details
Name
MARILLAC CLINIC, INC.
Subdivision Name
Marillac Clinic-Grand Junction
Type
HRSA-Funded Health Center
Site ID
BPS-H80-015058
340B ID
CHC28356-00
Grant Number
H80CS28356
Additional Details
Current Program Status
Active
Registration Date
7/6/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/13/2017
Last Recertification Date
2/13/2025
Contacts
Authorizing Official
Marillac Clinic Inc
Kay Ramachandran, CEO
(970) 200-1629
Primary Contact
Freedom Advising
Jeremy John Carroll, CFO
(832) 443-7395
Addresses
Street Address
2333 N 6TH ST
GRAND JUNCTION, CO 81501-2001
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
April 2025
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