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CH05291M Family Medical Center of Michigan Inc (Terminated)
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Main Details
Name
Family Medical Center of Michigan Inc
Subdivision Name
Family Medical Center - Deerfield School
Type
HRSA-Funded Health Center
Site ID
BPS-H80-021263
340B ID
CH05291M
Grant Number
H80CS00390
Additional Details
Current Program Status
Terminated
Registration Date
11/14/2017
Participating Start Date
1/1/2018
Participating Approval Date
11/15/2017
Last Recertification Date
2/19/2019
Termination Date
Termination Reason
1/1/2020
Business decision by the Covered Entity
Contacts
Authorizing Official
Family Medical Center of Michigan, Inc.
ED LARKINS, CEO
(734) 847-3802 Ext: 1412
Primary Contact
Family Medical Center of Michigan
Chris Croley, C.F.O.
(734) 847-3802 Ext: 1434
Addresses
Street Address
252 Deerfield Rd, Rm. 31
Deerfield, MI 49238
Billing Address
Family Medical Center
8765 Lewis Ave
Temperance, MI 48182
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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