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CH062793P East Texas Border Health Clinic (Active)
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Main Details
Name
East Texas Border Health Clinic
Subdivision Name
ETBHC Genesis PrimeCare -Texarkana AR #2
Type
HRSA-Funded Health Center
Site ID
BPS-H80-027185
340B ID
CH062793P
Grant Number
H80CS08781
Additional Details
Current Program Status
Active
Registration Date
4/8/2019
Participating Start Date
7/1/2019
Participating Approval Date
4/10/2019
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
Genesis PrimeCare
Carla Roadcap, CEO
(903) 927-3782
Primary Contact
Genesis PrimeCare
Kimberly Casey, credentailing
(903) 927-3782 Ext: 3105
Addresses
Street Address
4077 JEFFERSON AVENUE
Texarkana, AR 71854-1509
Billing Address
East Texas Border Health Clinic dba Genesis PrimeCare
PO Box 1326
Marshall, TX 75671-1326
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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