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CH0421240 FAIRVIEW COMMUNITY HEALTH CENTER (Active)
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Main Details
Name
FAIRVIEW COMMUNITY HEALTH CENTER
Subdivision Name
DBA FAIRVIEW COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-027674
340B ID
CH0421240
Grant Number
H80CS00856
Additional Details
Current Program Status
Active
Registration Date
10/1/2001
Participating Start Date
10/1/2001
Participating Approval Date
10/18/2004
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
Bowling Green Warren County Primary Care Inc DBA: Fairview Community Health Center
John Lillybridge, Executive Director
(270) 783-3573 Ext: 1032
Primary Contact
Fairview Community Health Center
Jennifer Gray, Medical Director
(270) 783-3573 Ext: 1021
Addresses
Street Address
225 NATCHEZ TRACE AVE
BOWLING GREEN, KY 42103-7995
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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10/27/06 UPDATED ENTITY NAME (WAS BOWLING GREEN WARREN CO PRIMARY CARE CTR); UPDATED ADDR (WAS 1109 STATE STREET); 10/18/04 ID # CORRECTION REPLACES FQ19/CH0421240;
01/12/2010
May 2025
May 2025
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