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CH05209A MILWAUKEE HEALTH SERVICES, INC. (Active)
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Main Details
Name
MILWAUKEE HEALTH SERVICES, INC.
Subdivision Name
ISAAC COGGS HERITAGE HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-004671
340B ID
CH05209A
Grant Number
H80CS00826
Additional Details
Current Program Status
Active
Registration Date
12/1/1993
Participating Start Date
12/1/1993
Participating Approval Date
1/21/2010
Last Recertification Date
2/14/2025
Contacts
Authorizing Official
MHSI
Tito Izard, President/CEO
(414) 267-2021
Primary Contact
Milwaukee Health Services, Inc.
Michele LeBourgeois, Chief Operations Officer
(414) 267-2026
Addresses
Street Address
8200 W Silver Spring Dr
Milwaukee, WI 53218
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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12/12/06 UPDATED ADDR (WAS 2555 N. MARTIN LUTHER KING DR., MILWAUKEE, WI 53212); 12/12/06 UPDATED SUBDIV NAME (WAS ISAAC COGGS HEALTH CONNECTION, INC/MLK HERITAGE HEALTH CENTER); 7/22/07 UPDATED MEDICAID # (WAS 33212200)
01/21/2010
June 2025
June 2025
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