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CHC33651-00 TULIP TREE HEALTH SERVICES OF GIBSON COUNTY, INC. (Terminated)
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Main Details
Name
TULIP TREE HEALTH SERVICES OF GIBSON COUNTY, INC.
Subdivision Name
Tulip Tree Health Services of Gibson County, Inc. d/b/a Tulip Tree Family Health Care
Type
HRSA-Funded Health Center
Site ID
BPS-H80-029612
340B ID
CHC33651-00
Grant Number
H80CS33651
Additional Details
Current Program Status
Terminated
Registration Date
7/12/2022
Participating Start Date
10/1/2022
Participating Approval Date
7/15/2022
Last Recertification Date
2/27/2023
Termination Date
Termination Reason
4/1/2024
Failure to recertify
Contacts
Authorizing Official
Tulip Tree Health Services of Gibson County, Inc.
Kristine Georges, Executive Director
(812) 753-1039
Primary Contact
Tulip Tree Health Services of Gibson County, Inc.
Andrew Russell, Manager of Quality & Compliance
(812) 753-1039
Addresses
Street Address
123 N Mccreary St
Fort Branch, IN 47648-1313
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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