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CH05332CU Southern Illinois Health Care Foundation, Inc. (Terminated)
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Main Details
Name
Southern Illinois Health Care Foundation, Inc.
Subdivision Name
BELLEVILLE FAMILY HEALTH
Type
HRSA-Funded Health Center
Site ID
BPS-H80-002277
340B ID
CH05332CU
Grant Number
H80CS00195
Additional Details
Current Program Status
Terminated
Registration Date
10/12/2017
Participating Start Date
1/1/2018
Participating Approval Date
11/20/2017
Last Recertification Date
2/12/2018
Termination Date
Termination Reason
10/1/2018
Site closure
Contacts
Authorizing Official
SIHF Healthcare
Larry McCulley, President
(618) 332-0694 Ext: 155
Primary Contact
SIHF Healthcare
Patrice M Howard, Senior Vice President
(618) 332-0694
Addresses
Street Address
180 S 3rd St, Suite 201
Belleville, IL 62220-1952
Billing Address
SIHF Healthcare
2041 Goose Lake Road
Sauget, IL 62206
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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