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CH04880E JEFFERSON COMPREHENSIVE HEALTH CENTER INC (Active)
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Main Details
Name
JEFFERSON COMPREHENSIVE HEALTH CENTER INC
Subdivision Name
Jefferson Comprehensive Health Center Medical/Dental Mobile Unit
Type
HRSA-Funded Health Center
Site ID
BPS-H80-030339
340B ID
CH04880E
Grant Number
H80CS00582
Additional Details
Current Program Status
Active
Registration Date
1/17/2023
Participating Start Date
4/1/2023
Participating Approval Date
1/19/2023
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
Jefferson Comprehensive Health Center, Inc.
Katrina Collins, Chief Executive Officer
(601) 786-3475
Primary Contact
Jefferson Comprehensive Health Center, Inc.
Charo Jackson, Chief Financial Officer
(601) 786-3475
Addresses
Street Address
405 Main St
Fayette, MS 39069-5576
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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May 2025
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