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FQHCLA402A Good Samaritan Family Health Center Inc. (Active)
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Main Details
Name
Good Samaritan Family Health Center Inc.
Subdivision Name
Martin County Family Health Center
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-036707
340B ID
FQHCLA402A
Grant Number
LALCS33817
Additional Details
Current Program Status
Active
Registration Date
7/12/2023
Participating Start Date
10/1/2023
Participating Approval Date
7/25/2023
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Good Samaritan Family Health Center
Jennifer Emmons, CEO
(812) 494-7800
Primary Contact
Good Samaritan Family Health Center Inc.
Traci French, Executive Director of Quality, IS, & Revenue Cycle
(812) 494-7100
Addresses
Street Address
200 S John F Kennedy Ave
Loogootee, IN 47553-1624
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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