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CHC00071-00 COVENANT HOUSE INC (Active)
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Main Details
Name
COVENANT HOUSE INC
Subdivision Name
Covenant House Health Services
Type
HRSA-Funded Health Center
Site ID
BPS-H80-003617
340B ID
CHC00071-00
Grant Number
H80CS00071
Additional Details
Current Program Status
Active
Registration Date
5/22/2023
Participating Start Date
7/1/2023
Participating Approval Date
5/23/2023
Last Recertification Date
2/18/2025
Contacts
Authorizing Official
Covenant House Inc.
Susan Stukes, Chief Executive Officer
(215) 844-1020 Ext: 219
Primary Contact
Covenant House Inc.
Phyllis Porter, Administrative Coordinator
(215) 844-1020 Ext: 221
Addresses
Street Address
251 E Bringhurst St
Philadelphia, PA 19144-1719
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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Participating Start Date 10/1/2017, Termination Date 4/1/2023, Reinstatement 7/1/2023
05/22/2023
April 2025
April 2025
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