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CH043823R BREVARD HEALTH ALLIANCE, INC., THE (Active)
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Main Details
Name
BREVARD HEALTH ALLIANCE, INC., THE
Subdivision Name
BHA Evans Center Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-023369
340B ID
CH043823R
Grant Number
H80CS04213
Additional Details
Current Program Status
Active
Registration Date
1/28/2019
Participating Start Date
4/1/2019
Participating Approval Date
1/29/2019
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Brevard Health Alliance
Austin Helton, CEO
(321) 241-6854
Primary Contact
Brevard Health Alliance
Reem Natafji, Chief Pharmacy Officer
(321) 342-9706
Addresses
Street Address
1361 Florida Ave NE
STE 2
Palm Bay, FL 32905-2650
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
April 2025
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