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FQHCLA428 Holy Family Medical, Inc. (Active)
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Main Details
Name
Holy Family Medical, Inc.
Subdivision Name
Holy Family Medical
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-032535
340B ID
FQHCLA428
Grant Number
LALCS42065
Additional Details
Current Program Status
Active
Registration Date
7/2/2021
Participating Start Date
10/1/2021
Participating Approval Date
9/8/2021
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
HOLY FAMILY MEDICAL INC
BRENDA THANEL, CEO
(316) 682-9900 Ext: 200
Primary Contact
Holy Family Medical, Inc.
Ronald Ferris, CMO
(316) 682-9900 Ext: 400
Addresses
Street Address
144 S Hillside St
Wichita, KS 67211-2154
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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May 2025
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