340B Drug Pricing Program Database
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CHC26566-19 Jane Pauley Community Health Center, Inc. (Terminated)
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Main Details
Name
Jane Pauley Community Health Center, Inc.
Subdivision Name
Jane Pauley Community Health Center at St. Mary School
Type
HRSA-Funded Health Center
Site ID
BPS-H80-020791
340B ID
CHC26566-19
Grant Number
H80CS26566
Additional Details
Current Program Status
Terminated
Registration Date
7/13/2018
Participating Start Date
10/1/2018
Participating Approval Date
8/24/2018
Last Recertification Date
1/30/2023
Termination Date
Termination Reason
10/1/2023
Business decision by the Covered Entity
Contacts
Authorizing Official
Jane Pauley Community Health Center
Dale Marion, 340B Program Manager
(317) 552-0690
Primary Contact
Jane Pauley CHC
Michael Dale, CFO
(317) 934-0751
Addresses
Street Address
820 West Madison Avenue Zimmerman Hall
Alexandria, IN 46001
Billing Address
Jane Pauley Community Health Center, Inc.
1503 N. Mitthoeffer Road
Indianapolis, IN 46229
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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