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FQHCLA391K 219 HEALTH NETWORK INC (Active)
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Main Details
Name
219 HEALTH NETWORK INC
Subdivision Name
219 Health Network Inc.
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-032461
340B ID
FQHCLA391K
Grant Number
LALCS32751
Additional Details
Current Program Status
Active
Registration Date
7/1/2021
Participating Start Date
10/1/2021
Participating Approval Date
8/25/2021
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
ST CATHERINE HOSPITAL
Leo Correa, Administrator and CEO
(219) 392-7004
Primary Contact
219 Health Network
Richard Santay, Pharmacy Business Manager
(219) 392-7472
Addresses
Street Address
9130 Columbia Ave Ste A
Munster, IN 46321-2932
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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