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FQHCLA450 LOGAN-MINGO AREA MENTAL HEALTH INC (Active)
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Main Details
Name
LOGAN-MINGO AREA MENTAL HEALTH INC
Subdivision Name
Logan Mingo Area Mental Health, Inc.
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-030259
340B ID
FQHCLA450
Grant Number
LALCS33895
Additional Details
Current Program Status
Active
Registration Date
7/13/2023
Participating Start Date
10/1/2023
Participating Approval Date
9/6/2023
Last Recertification Date
2/12/2025
Contacts
Authorizing Official
Logan Mingo Area Mental Health, Inc.
Donna J. Cooke, Chief Executive Officer
(304) 792-7130 Ext: 1045
Primary Contact
Logan Mingo Area Mental Health, Inc.
Patrick Duty, Pharmacist
(304) 792-7130
Addresses
Street Address
174 LMAMH Center Road
Logan, WV 25601
Billing Address
Logan Mingo Area Mental Health, Inc.
PO Box 176
Logan, WV 25601
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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