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CH07530L Family Health Center of Boone County (Terminated)
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Main Details
Name
Family Health Center of Boone County
Subdivision Name
Family Health Center Moberly
Type
HRSA-Funded Health Center
Site ID
BPS-H80-030480
340B ID
CH07530L
Grant Number
H80CS00573
Additional Details
Current Program Status
Terminated
Registration Date
4/10/2020
Participating Start Date
7/1/2020
Participating Approval Date
4/13/2020
Last Recertification Date
Termination Date
Termination Reason
1/1/2021
Other
Contacts
Authorizing Official
Family Health Center of Boone County
Jack Kelly, Chief Executive Officer
(573) 886-6713
Primary Contact
Family Health Center of Boone County
Darren L Stice, Chief Financial Officer
(573) 886-6714
Addresses
Street Address
1319 E Highway 24 Ste B
Moberly, MO 65270-3682
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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