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RWI19147 Mazzoni Center (Active)
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Main Details
Name
Mazzoni Center
Subdivision Name
Type
Ryan White Part A
340B ID
RWI19147
Grant Number
H89HA00013
Additional Details
Current Program Status
Active
Registration Date
1/14/2018
Participating Start Date
4/1/2018
Participating Approval Date
2/14/2018
Last Recertification Date
2/17/2025
Time Period the Assistance was Received
3/1/2024 - 2/28/2026
Contacts
Authorizing Official
Mazzoni Center
Alecia Manley, Executive Operating Officer
(215) 563-0652
Primary Contact
Mazzoni Center
Valerie Canavin, Compliance Director
(215) 563-0652
Addresses
Street Address
1348 Bainbridge Street
Philadelphia, PA 19147-1810
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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June 2025
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