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CH05306AV Sixteenth Street Community Health Centers, Inc. (Terminated)
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Main Details
Name
Sixteenth Street Community Health Centers, Inc.
Subdivision Name
Sixteenth Street Community Health Centers - UCC Childcare and Early Learning Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-024934
340B ID
CH05306AV
Grant Number
H80CS00593
Additional Details
Current Program Status
Terminated
Registration Date
4/9/2020
Participating Start Date
7/1/2020
Participating Approval Date
4/22/2020
Last Recertification Date
2/16/2022
Termination Date
Termination Reason
4/1/2022
Other
Contacts
Authorizing Official
Sixteenth Street Community Health Centers
Liz Claudio, Vice President, Operations
(414) 897-5165
Primary Contact
Sixteenth Street Community Health Centers
Jason A Jenders, Director of Pharmacy
(414) 897-5497
Addresses
Street Address
2210 W Becher St RM 101
Milwaukee, WI 53215-2561
Billing Address
Sixteenth Street Community Health Centers, Inc.
1337 S. Cesar E Chavez Dr
Milwaukee, WI 53204-2712
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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