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CH05290M COMMUNITY ACTION COMMITTEE OF PIKE COUNTY, THE (Terminated)
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Main Details
Name
COMMUNITY ACTION COMMITTEE OF PIKE COUNTY, THE
Subdivision Name
Valley View Health Center-Emmitt Ave
Type
HRSA-Funded Health Center
Site ID
BPS-H80-024761
340B ID
CH05290M
Grant Number
H80CS00399
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
1/31/2024
Termination Date
Termination Reason
4/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
CAC of Pike County
Keith Pitts, President and Chief Executive Officer
(216) 770-3409 Ext: 7009
Primary Contact
Community Action Committee of Pike County
Michael Adair Mercer, Director of Pharmacy Services
(216) 304-2462 Ext: 7363
Addresses
Street Address
715 W Emmitt Avenue
Waverly, OH 45690-1015
Billing Address
Community Action Committee of Pike County
941 Market St
PO Box 799
Piketon, OH 45661
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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