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CH062793M East Texas Border Health Clinic (Active)
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Main Details
Name
East Texas Border Health Clinic
Subdivision Name
Genesis Primecare-First Pediatrics
Type
HRSA-Funded Health Center
Site ID
BPS-H80-020861
340B ID
CH062793M
Grant Number
H80CS08781
Additional Details
Current Program Status
Active
Registration Date
10/15/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/17/2017
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
Genesis PrimeCare
Carla Roadcap, CEO
(903) 927-3782
Primary Contact
Genesis PrimeCare
Kimberly Casey, credentailing
(903) 927-3782 Ext: 3105
Addresses
Street Address
620 South Grove Street, Suite 105
Marshall, TX 75670
Billing Address
Genesis PrimeCare
PO Box 1326
Marshall, TX 75671
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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