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CH09287K Chiricahua Community Health Centers, Inc. (Terminated)
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Main Details
Name
Chiricahua Community Health Centers, Inc.
Subdivision Name
CCHCI SEABHS Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-019614
340B ID
CH09287K
Grant Number
H80CS00696
Additional Details
Current Program Status
Terminated
Registration Date
11/16/2017
Participating Start Date
1/1/2018
Participating Approval Date
11/16/2017
Last Recertification Date
2/13/2024
Termination Date
Termination Reason
7/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
chiricahua community health centers
Jonathan Melk, CEO
(520) 227-9167
Primary Contact
Chiricahua Community Health Centers
David Andrew Merrell, Pharmacy Director
(480) 202-2497
Addresses
Street Address
4755 Campus Drive
Sierra Vista, AZ 85635
Billing Address
Chiricahua Community Health Centers, Inc.
1205 f avenue
Douglas, AZ 85607
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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