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CH05022D INTERCARE COMMUNITY HEALTH NETWORK (Active)
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Main Details
Name
INTERCARE COMMUNITY HEALTH NETWORK
Subdivision Name
INTERCARE BENTON HARBOR
Type
HRSA-Funded Health Center
Site ID
BPS-H80-010896
340B ID
CH05022D
Grant Number
H80CS00771
Additional Details
Current Program Status
Active
Registration Date
7/1/1998
Participating Start Date
7/1/1998
Participating Approval Date
3/10/2005
Last Recertification Date
2/17/2025
Contacts
Authorizing Official
InterCare Community Health Network
VELMA HENDERSHOTT, CEO
(269) 427-7937 Ext: 200
Primary Contact
InterCare Community Health Network
John McElwee, Chief Financial Office
(269) 427-7937
Addresses
Street Address
800 M-139
Benton Harbor, MI 49022
Billing Address
INTERCARE COMMUNITY HEALTH NETWORK - ADMINISTRATIVE OFFICE
50 INDUSTRIAL PARK RD
BANGOR, MI 49013-1246
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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11/4/07 UPDATED ADDR (WAS ZIP: 49013);3/10/05 UPDATED BILL TO; 3/10/05 UPDATED ENTITY NAME;
01/14/2010
April 2025
April 2025
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