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CH07055AN Primary Health Care Inc (Terminated)
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Main Details
Name
Primary Health Care Inc
Subdivision Name
Primary Health Care - Marshalltown Specialty Health
Type
HRSA-Funded Health Center
Site ID
BPS-H80-027274
340B ID
CH07055AN
Grant Number
H80CS00715
Additional Details
Current Program Status
Terminated
Registration Date
2/26/2019
Participating Start Date
4/1/2019
Participating Approval Date
2/27/2019
Last Recertification Date
2/8/2021
Termination Date
Termination Reason
4/1/2022
Site closure
Contacts
Authorizing Official
Primary Health Care
Kelly Huntsman, CEO
(515) 248-1441
Primary Contact
Primary Health Care
Heidi Price-Eastman, Pharmacy Director
(515) 248-1558
Addresses
Street Address
704 May St
Marshalltown, IA 50158-3437
Billing Address
Primary Health Care, Inc
1200 University Ave
200
Des Moines, IA 50314
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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