340B Drug Pricing Program Database

Name

LifeBridge Community Services, Inc.

Subdivision Name

Type

Ryan White Part A

340B ID

RWI06605

Grant Number

H89HA00029

Current Program Status

Terminated

Registration Date

7/14/2020

Participating Start Date

10/1/2020

Participating Approval Date

8/4/2020

Last Recertification Date

Time Period the Assistance was Received

Termination Date
Termination Reason

4/1/2021
Failure to recertify

Authorizing Official

LifeBridgeCommunity Services, Inc.
Alan J Mathis, President & CEO
(203) 368-5517

Primary Contact

LifeBridge Community Services, Inc.
Frank Farias, Chief Financial Officer
(203) 368-5517

Street Address

475 Clinton Avenue
Bridgeport, CT 06605

Billing Address
Same as Street Address