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FQHCLA359 Southern Indiana Community Health Care Inc (Terminated)
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Main Details
Name
Southern Indiana Community Health Care Inc
Subdivision Name
Patoka Family Health Care
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-021365
340B ID
FQHCLA359
Grant Number
LALCS31528
Additional Details
Current Program Status
Terminated
Registration Date
12/12/2017
Participating Start Date
1/1/2018
Participating Approval Date
12/14/2017
Last Recertification Date
2/19/2019
Termination Date
Termination Reason
4/1/2020
Failure to recertify
Contacts
Authorizing Official
Southern Indiana Community Health Care
Nancy Radcliff, CEO
(812) 723-3944
Primary Contact
Southern Indiana Community Health Care
Katarina Koch, Fund development manager
(812) 272-4804
Addresses
Street Address
307 S. Indiana Ave.
English, IN 47118
Billing Address
Southern Indiana Community Health Care
PO Box 270
Paoli, IN 47454
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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