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CH03122L N Penn Comprehensive Health Svcs (Active)
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Main Details
Name
N Penn Comprehensive Health Svcs
Subdivision Name
Wellsboro Laurel Pediatric Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-027690
340B ID
CH03122L
Grant Number
H80CS00682
Additional Details
Current Program Status
Active
Registration Date
10/15/2019
Participating Start Date
1/1/2020
Participating Approval Date
10/16/2019
Last Recertification Date
3/5/2025
Contacts
Authorizing Official
North Penn Comprehensive Health Services
Ronald M Gilbert, CFO
(570) 828-3869
Primary Contact
North Penn Comprehensive Health Services
Brandi Fitzwater, Controller
(570) 662-1951
Addresses
Street Address
1B Main St
Wellsboro, PA 16901-1601
Billing Address
North Penn Comprehensive Health Services
40 West Wellsboro St
Mansfield, PA 16933
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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