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FQHCLA450A 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-030260
340B ID
FQHCLA450A
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
2954 Buffalo Creek Road
Chattaroy, WV 25667
Billing Address
Logan Mingo Area Mental Health, Inc.
PO Box 185
Chattaroy, WV 25667
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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