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HV01708B NORTHWEST GEORGIA HEALTH DISTRICT SPECIALTY CARE CLINIC (Active)
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Main Details
Name
NORTHWEST GEORGIA HEALTH DISTRICT SPECIALTY CARE CLINIC
Subdivision Name
Type
Ryan White Part C
340B ID
HV01708B
Grant Number
H76HA00806
Additional Details
Current Program Status
Active
Registration Date
4/13/2020
Participating Start Date
7/1/2020
Participating Approval Date
5/1/2020
Last Recertification Date
2/12/2025
Time Period the Assistance was Received
4/1/2023 - 3/31/2025
Contacts
Authorizing Official
NORTHWEST HEALTH DISTRICT 1-1
Cheryl Bandy, Nursing and Clinical Director
(706) 802-5219
Primary Contact
Northwest Georgia Health District
RISE WOOD, DISTRICT PHARMACIST
(706) 802-5430
Addresses
Street Address
16 EAST 12TH STREET
SUITE 202
ROME, GA 30161
Billing Address
NORTHWEST HEALTH DISTRICT 1-1
1309 REDMOND ROAD NW
ROME, GA 30165
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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June 2025
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