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CH05306AS Sixteenth Street Community Health Centers, Inc. (Terminated)
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Main Details
Name
Sixteenth Street Community Health Centers, Inc.
Subdivision Name
Sixteenth Street Community Health Centers-Chavez
Type
HRSA-Funded Health Center
Site ID
BPS-H80-001579
340B ID
CH05306AS
Grant Number
H80CS00593
Additional Details
Current Program Status
Terminated
Registration Date
4/4/2018
Participating Start Date
7/1/2018
Participating Approval Date
4/19/2018
Last Recertification Date
2/20/2019
Termination Date
Termination Reason
10/1/2019
Other
Contacts
Authorizing Official
Sixteenth Street Community Health Center
Michael Maschek, Vice President Finance and Strategy
(414) 897-5156
Primary Contact
Sixteenth Street Community Health Centers
Jason A Jenders, Director of Pharmacy
(414) 897-5497
Addresses
Street Address
1032 S Cesar E Chavez Dr
Milwaukee, WI 53204-2203
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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