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CH05847Q Columbus Neighborhood Health Center, Inc. (Terminated)
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Main Details
Name
Columbus Neighborhood Health Center, Inc.
Subdivision Name
PrimaryOne Health 1289 East Livingston Avenue
Type
HRSA-Funded Health Center
Site ID
BPS-H80-024998
340B ID
CH05847Q
Grant Number
H80CS00118
Additional Details
Current Program Status
Terminated
Registration Date
4/23/2019
Participating Start Date
7/1/2019
Participating Approval Date
4/23/2019
Last Recertification Date
2/3/2023
Termination Date
Termination Reason
7/1/2023
Site closure
Contacts
Authorizing Official
PrimaryOne Health
Charleta B. Tavares, CEO
(614) 859-1880
Primary Contact
Columbus Neighborhood Health Center, Inc.
Dewitt D Harrell, Chief Financial Officer
(614) 859-1902
Addresses
Street Address
1289 E Livingston Ave
Columbus, OH 43205-2838
Billing Address
PrimaryOne Health
2780 Airport Drive, Suite 100
Columbus, OH 43219
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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