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FQHCLA429B Physicians Care of Clarke (Terminated)
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Main Details
Name
Physicians Care of Clarke
Subdivision Name
Physicians Care of Thomasville
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-032798
340B ID
FQHCLA429B
Grant Number
LALCS43504
Additional Details
Current Program Status
Terminated
Registration Date
10/1/2021
Participating Start Date
1/1/2022
Participating Approval Date
10/4/2021
Last Recertification Date
2/1/2023
Termination Date
Termination Reason
4/1/2024
Other
Contacts
Authorizing Official
PHYSICIANS CARE
FARRELL A TURNER, CEO
(256) 201-0095
Primary Contact
PHYSICIANS CARE
CHAD SHADEL, CFO
(630) 863-3907
Addresses
Street Address
33621 Hwy 43
Thomasville, AL 36784-3309
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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