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RWI23669 LGBT Life Center (Terminated)
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Main Details
Name
LGBT Life Center
Subdivision Name
Type
Ryan White Part A
340B ID
RWI23669
Grant Number
H89HA00053
Additional Details
Current Program Status
Terminated
Registration Date
10/6/2017
Participating Start Date
1/1/2018
Participating Approval Date
11/21/2017
Last Recertification Date
1/29/2019
Time Period the Assistance was Received
Termination Date
Termination Reason
4/1/2020
Never implemented the 340B Program
Contacts
Authorizing Official
LGBT Life Center
Stacie Walls-Beegle, CEO
(757) 640-0929 Ext: 215
Primary Contact
LGBT Life Center
Jenny Carter-Domke, Director of Client Services
(757) 640-0929 Ext: 616
Addresses
Street Address
20 Settlers Landing
Hampton, VA 23669
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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April 2025
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