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CH07119AB Affinia Healthcare (Terminated)
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Main Details
Name
Affinia Healthcare
Subdivision Name
BJC Behavioral Health
Type
HRSA-Funded Health Center
Site ID
BPS-H80-000009
340B ID
CH07119AB
Grant Number
H80CS00415
Additional Details
Current Program Status
Terminated
Registration Date
5/16/2018
Participating Start Date
7/1/2018
Participating Approval Date
5/23/2018
Last Recertification Date
2/5/2024
Termination Date
Termination Reason
4/1/2025
Business decision by the Covered Entity
Contacts
Authorizing Official
Affinia Healthcare
Leslie S O'Connor, CFO
(618) 343-5786
Primary Contact
Affinia Healthcare
Kendra Holmes, President CEO
(314) 779-7530
Addresses
Street Address
1430 Olive Street STE 400
St. Louis, MO 63101
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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