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FQHCLA446 ALLIANCE HEALTH CENTERS INC (Active)
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Main Details
Name
ALLIANCE HEALTH CENTERS INC
Subdivision Name
Alliance Health Center
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-033700
340B ID
FQHCLA446
Grant Number
LALCS45370
Additional Details
Current Program Status
Active
Registration Date
4/12/2023
Participating Start Date
7/1/2023
Participating Approval Date
6/5/2023
Last Recertification Date
3/5/2025
Contacts
Authorizing Official
Alliance Health Center
Autumn N King, CEO
(606) 634-1456
Primary Contact
Alliance Health Centers, inc
Aiwen Liu, Medical Director
(260) 266-0780
Addresses
Street Address
2700 Lafayette St STE 110
Fort Wayne, IN 46806-1100
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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