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CHC22679-02 ELAINE ELLIS CENTER OF HEALTH, INC. (Active)
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Main Details
Name
ELAINE ELLIS CENTER OF HEALTH, INC.
Subdivision Name
Kenilworth
Type
HRSA-Funded Health Center
Site ID
BPS-H80-021268
340B ID
CHC22679-02
Grant Number
H80CS22679
Additional Details
Current Program Status
Active
Registration Date
10/14/2021
Participating Start Date
1/1/2022
Participating Approval Date
10/22/2021
Last Recertification Date
2/17/2025
Contacts
Authorizing Official
Elaine Ellis Center of Health
Timothy Walker, COO
(202) 803-2340
Primary Contact
Elaine Ellis Center of Health
Kate Milone, Director of Quality and Compliance
(202) 803-2340
Addresses
Street Address
1627 Kenilworth Ave NE
Washington, DC 20019-2010
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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