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FQHCLA402 Good Samaritan Family Health Center Inc. (Active)
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Main Details
Name
Good Samaritan Family Health Center Inc.
Subdivision Name
Family Health Center
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-031404
340B ID
FQHCLA402
Grant Number
LALCS33817
Additional Details
Current Program Status
Active
Registration Date
10/7/2019
Participating Start Date
1/1/2020
Participating Approval Date
12/10/2019
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Good Samaritan Family Health Center
Jennifer Emmons, CEO
(812) 494-7800
Primary Contact
Good Samaritan Family Health Center Inc.
Traci French, Executive Director of Quality, IS, & Revenue Cycle
(812) 494-7100
Addresses
Street Address
1027 Washington Avenue
Suite B
Vincennes, IN 47591
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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