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CH04039S Medlink Georgia, Inc (Terminated)
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Main Details
Name
Medlink Georgia, Inc
Subdivision Name
MedLink White
Type
HRSA-Funded Health Center
Site ID
BPS-H80-021314
340B ID
CH04039S
Grant Number
H80CS00427
Additional Details
Current Program Status
Terminated
Registration Date
1/9/2018
Participating Start Date
4/1/2018
Participating Approval Date
1/10/2018
Last Recertification Date
Termination Date
Termination Reason
4/1/2018
Other
Contacts
Authorizing Official
Medlink Georgia, Inc
Dave Ward, CEO
(706) 788-3234
Primary Contact
MedLink Georgia, Inc
Joey W Forman, Strategic Initiative Program Manager
(706) 788-3234 Ext: 1025
Addresses
Street Address
17 White St
Cleveland, GA 30528-1140
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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