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CH04563W GASTON FAMILY HEALTH SERVICES INC (Terminated)
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Main Details
Name
GASTON FAMILY HEALTH SERVICES INC
Subdivision Name
Kintegra Family Medicine - Cherryville
Type
HRSA-Funded Health Center
Site ID
BPS-H80-018499
340B ID
CH04563W
Grant Number
H80CS00293
Additional Details
Current Program Status
Terminated
Registration Date
7/17/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/21/2017
Last Recertification Date
2/9/2021
Termination Date
Termination Reason
10/1/2021
Site closure
Contacts
Authorizing Official
Gaston Family Health Services
Robert Spencer, CEO
(704) 616-2245
Primary Contact
Gaston Family Health Services, Inc.
Marvin Patrick Allen, Director, Pharmacy Services
(704) 772-4642
Addresses
Street Address
112 S. Oak Street
Cherryville, NC 28021
Billing Address
Gaston Family Health Services, Inc.
200 East Second Avenue
Gastonia, NC 28052
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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