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CH07119AE Affinia Healthcare (Terminated)
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Main Details
Name
Affinia Healthcare
Subdivision Name
Aspire Academy Confluence Charter School
Type
HRSA-Funded Health Center
Site ID
BPS-H80-024589
340B ID
CH07119AE
Grant Number
H80CS00415
Additional Details
Current Program Status
Terminated
Registration Date
4/2/2019
Participating Start Date
7/1/2019
Participating Approval Date
4/9/2019
Last Recertification Date
1/29/2024
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
5421 Thekla Ave
Saint Louis, MO 63120-2513
Billing Address
Affinia Healthcare
1717 Biddle Street
St. Louis, MO 63106
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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