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FQHCLA426 Wabash General Hospital District (Active)
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Main Details
Name
Wabash General Hospital District
Subdivision Name
Wabash Community Health Center
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-035119
340B ID
FQHCLA426
Grant Number
LALCS41745
Additional Details
Current Program Status
Active
Registration Date
5/12/2021
Participating Start Date
5/12/2021
Participating Approval Date
5/12/2021
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Wabash Community Health Center
Cathy Ruth, Director
(618) 263-6186
Primary Contact
Wabash Community Health Center
Susan Leann Lear, PMH-NP, Medical Director
(618) 263-4970 Ext: 6178
Addresses
Street Address
1123 Chestnut Street
Mount Carmel, IL 62863-1948
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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