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CH03122M N Penn Comprehensive Health Svcs (Terminated)
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Main Details
Name
N Penn Comprehensive Health Svcs
Subdivision Name
Laurel Behavioral Health Outpatient Services
Type
HRSA-Funded Health Center
Site ID
BPS-H80-014877
340B ID
CH03122M
Grant Number
H80CS00682
Additional Details
Current Program Status
Terminated
Registration Date
10/15/2019
Participating Start Date
1/1/2020
Participating Approval Date
10/16/2019
Last Recertification Date
2/22/2022
Termination Date
Termination Reason
4/1/2023
Site closure
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
114 East Avenue
Wellsboro, PA 16901
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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