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CH07731H Community Health Centers Of Southeastern Iowa, Inc (Terminated)
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Main Details
Name
Community Health Centers Of Southeastern Iowa, Inc
Subdivision Name
CHC/SEIA Burlington Pediatric Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-031629
340B ID
CH07731H
Grant Number
H80CS00272
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2021
Participating Start Date
4/1/2021
Participating Approval Date
1/19/2021
Last Recertification Date
2/9/2024
Termination Date
Termination Reason
7/1/2024
Site closure
Contacts
Authorizing Official
Community Health Centers of Southeastern Iowa
Antonio Flores, CEO
(319) 753-2300 Ext: 122
Primary Contact
Community Health Centers of Southeastern Iowa
Ann Speers, Admin Support Services Manager
(319) 576-3779
Addresses
Street Address
1223 S Gear Ave Ste 108
West Burlington, IA 52655-1685
Billing Address
Community Health Centers of Southeastern Iowa, Inc.
407 Blondeau Ste 1
Keokuk, IA 52632
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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