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CH01058Z Providence Community Health Centers, Inc., The (Active)
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Main Details
Name
Providence Community Health Centers, Inc., The
Subdivision Name
Atwood Street Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-034053
340B ID
CH01058Z
Grant Number
H80CS00057
Additional Details
Current Program Status
Active
Registration Date
4/3/2022
Participating Start Date
7/1/2022
Participating Approval Date
4/8/2022
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
PCHC
MERRILL THOMAS, CEO
(401) 444-0400 Ext: 3130
Primary Contact
Providence Community Health Centers
Garrett Clark, CO
(401) 444-0400
Addresses
Street Address
31 Atwood St
Providence, RI 02909-3410
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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