340B Drug Pricing Program Database
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CHC26566-24 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 Smith Valley Road
Type
HRSA-Funded Health Center
Site ID
BPS-H80-024639
340B ID
CHC26566-24
Grant Number
H80CS26566
Additional Details
Current Program Status
Terminated
Registration Date
4/4/2019
Participating Start Date
7/1/2019
Participating Approval Date
4/5/2019
Last Recertification Date
1/28/2020
Termination Date
Termination Reason
7/1/2020
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 Community Health Center
Amanda Boyle, Executive Administrator
(317) 934-0755
Addresses
Street Address
1664 Smith Valley Road
Greenwood, IN 46142
Billing Address
Jane Pauley Community Health Center
1503 Mitthoeffer Road
Indianapolis, IN 46229
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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