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CH03224V Peninsula Institute For Community Health, Inc (Active)
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Main Details
Name
Peninsula Institute For Community Health, Inc
Subdivision Name
Warwick Boulevard Physicians
Type
HRSA-Funded Health Center
Site ID
BPS-H80-017928
340B ID
CH03224V
Grant Number
H80CS00073
Additional Details
Current Program Status
Active
Registration Date
7/2/2019
Participating Start Date
10/1/2019
Participating Approval Date
7/18/2019
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Peninsula Institue for Community Health
ANGELA FUTRELL, CEO
(757) 591-0643 Ext: 1120
Primary Contact
Peninsula Institute for Community Health
VALDA BRANCH, COO
(757) 223-7007
Addresses
Street Address
9294 Warwick Blvd
Newport News, VA 23607-1535
Billing Address
Southeastern Virginia Health System
1033 28th Street
Newport News, VA 23607
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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