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CH01058V PROVIDENCE COMMUNITY HEALTH CENTERS, INC., THE (Active)
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Main Details
Name
PROVIDENCE COMMUNITY HEALTH CENTERS, INC., THE
Subdivision Name
Randall Square Health Center Suite 205
Type
HRSA-Funded Health Center
Site ID
BPS-H80-019329
340B ID
CH01058V
Grant Number
H80CS00057
Additional Details
Current Program Status
Active
Registration Date
10/5/2017
Participating Start Date
1/1/2018
Participating Approval Date
11/6/2017
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
Providence Community Health Centers
Garrett Clark, CO
(401) 444-0400
Primary Contact
PCHC
Greg Young, CFO
(401) 444-0400 Ext: 3129
Addresses
Street Address
1 Randall Sq Ste 205
Providence, RI 02904-2709
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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