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CH04175S SUNCOAST COMMUNITY HEALTH CENTERS, INC. (Active)
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Main Details
Name
SUNCOAST COMMUNITY HEALTH CENTERS, INC.
Subdivision Name
Suncoast Mobile Dental Bus II
Type
HRSA-Funded Health Center
Site ID
BPS-H80-022005
340B ID
CH04175S
Grant Number
H80CS00541
Additional Details
Current Program Status
Active
Registration Date
10/1/2019
Participating Start Date
1/1/2020
Participating Approval Date
10/3/2019
Last Recertification Date
2/14/2025
Contacts
Authorizing Official
Suncoast Community Health Centers, Inc.
Bradley Herremans, CEO
(813) 653-6268
Primary Contact
Suncoast Community Health Centers, Inc.
Miosotis Peguero, Analyst – Finance & Pharmacy Compliance
(813) 349-7998
Addresses
Street Address
313 S Lakewood Dr.
Brandon, FL 33511-2815
Billing Address
Suncoast Community Health Centers, Inc.
P.O. Box 1349
Ruskin, FL 33575
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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