340B Drug Pricing Program Database
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CHC00341-08 PrimeCare Community Health, Inc. (Active)
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Main Details
Name
PrimeCare Community Health, Inc.
Subdivision Name
PrimeCare Young Family Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-036204
340B ID
CHC00341-08
Grant Number
H80CS00341
Additional Details
Current Program Status
Active
Registration Date
12/11/2020
Participating Start Date
1/1/2021
Participating Approval Date
12/14/2020
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
PrimeCare Community Health
Michael C Holtrop, Chief Financial Officer
(616) 482-9892
Primary Contact
PRIMECARE COMMUNITY HEALTH INC
Kenzie Keisler, Interim 340B Compliance Analyst
(803) 465-2011
Addresses
Street Address
1431 N Western Ave
Ste 202
Chicago, IL 60622
Billing Address
PrimeCare Community Health
2211 N. Elston Ave
Suite 301
Chicago, IL 60614
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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