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CH04100A WAKE HEALTH SERVICES, INC. (Terminated)
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Main Details
Name
WAKE HEALTH SERVICES, INC.
Subdivision Name
Southeast Raleigh - South
Type
HRSA-Funded Health Center
Site ID
BPS-H80-003413
340B ID
CH04100A
Grant Number
H80CS00087
Additional Details
Current Program Status
Terminated
Registration Date
7/1/2001
Participating Start Date
7/1/2001
Participating Approval Date
1/21/2010
Last Recertification Date
3/8/2016
Termination Date
Termination Reason
7/1/2016
Site closure
Contacts
Authorizing Official
Penella M. Washington, CEO
(919) 250-2923
Primary Contact
Charles Faust, COO
(919) 250-2978
Addresses
Street Address
1011 Rock Quarry Rd
Raleigh, NC 27610-3825
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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12/20/05 UPDATED ENTITY NAME
01/21/2010
May 2025
May 2025
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