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CHC33656-04 Upstate Family Health Center, Inc. (Terminated)
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Main Details
Name
Upstate Family Health Center, Inc.
Subdivision Name
Upstate Family Health Center, Inc. Rome
Type
HRSA-Funded Health Center
Site ID
BPS-H80-029561
340B ID
CHC33656-04
Grant Number
H80CS33656
Additional Details
Current Program Status
Terminated
Registration Date
4/9/2020
Participating Start Date
7/1/2020
Participating Approval Date
4/13/2020
Last Recertification Date
2/6/2024
Termination Date
Termination Reason
7/1/2024
Site closure
Contacts
Authorizing Official
Upstate Family Health Center Inc
Andreea Cristina Mera, CEO
(917) 864-7308
Primary Contact
Upstate Family Health Center Inc
Christine Tennant, Director of Quality and Compliance
(315) 624-9470 Ext: 2261
Addresses
Street Address
205 West Dominick Street Suite A
Rome, NY 13440-5811
Billing Address
Upstate Family Health Center, Inc.
1001 Noyes Street
UTICA, NY 13502
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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