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CHC08784-19 LAKES COMMUNITY HEALTH CENTER, INC., THE (Terminated)
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Main Details
Name
LAKES COMMUNITY HEALTH CENTER, INC., THE
Subdivision Name
NorthLakes Community Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-027414
340B ID
CHC08784-19
Grant Number
H80CS08784
Additional Details
Current Program Status
Terminated
Registration Date
7/1/2019
Participating Start Date
10/1/2019
Participating Approval Date
7/9/2019
Last Recertification Date
2/1/2021
Termination Date
Termination Reason
4/1/2022
Business decision by the Covered Entity
Contacts
Authorizing Official
The Lakes Community Health Center
Jason Akl, COO
(715) 372-5001
Primary Contact
The Lakes Community Health Center
Christine Marie Dryer, Pharmacy Director
(715) 372-5011
Addresses
Street Address
218 Main St W
Ashland, WI 54806-1606
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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