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CH051741K Shalom Health Care Center, Inc. (Active)
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Main Details
Name
Shalom Health Care Center, Inc.
Subdivision Name
Shalom Health Care Center PHC Mobile Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-028354
340B ID
CH051741K
Grant Number
H80CS00880
Additional Details
Current Program Status
Active
Registration Date
10/14/2019
Participating Start Date
1/1/2020
Participating Approval Date
10/16/2019
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Shalom Health Care Center
Leonardo R. Ortega, Executive Director/CEO
(317) 291-7422 Ext: 1105
Primary Contact
Shalom Health Center
Bianca Daisy-Bell, Clinical Pharmacist
(317) 291-7422 Ext: 1422
Addresses
Street Address
3400 LAFAYETTE RD STE 200
INDIANAPOLIS, IN 46222-1147
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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