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CHC12846-03 Purdue University (Active)
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Main Details
Name
Purdue University
Subdivision Name
Family Health Clinic of Monon
Type
HRSA-Funded Health Center
Site ID
BPS-H80-024942
340B ID
CHC12846-03
Grant Number
H80CS12846
Additional Details
Current Program Status
Active
Registration Date
10/6/2023
Participating Start Date
1/1/2024
Participating Approval Date
11/22/2023
Last Recertification Date
2/18/2025
Contacts
Authorizing Official
Family Health Clinics- Purdue University
Sherri Gehlhausen, Director of Revenue Cycle
(765) 564-3016
Primary Contact
Family Health Clinics- Purdue University
Jennifer Coddington, Medical Director
(765) 494-9067
Addresses
Street Address
692 E Broadway St
Monon, IN 47959-8191
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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