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CH048420 Claiborne County Family Health Center (Active)
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Main Details
Name
Claiborne County Family Health Center
Subdivision Name
CLAIBORNE COUNTY FAMILY HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-001310
340B ID
CH048420
Grant Number
H80CS00482
Additional Details
Current Program Status
Active
Registration Date
8/2/2018
Participating Start Date
10/1/2018
Participating Approval Date
8/6/2018
Last Recertification Date
2/17/2025
Contacts
Authorizing Official
Claiborne County Family Health Center
LaDonna Davis, COO
(601) 437-3052 Ext: 6014373050
Primary Contact
Claiborne County Family Health Center
Anita Moore, Purchasing
(601) 437-3049
Addresses
Street Address
2045 Highway 61 N
Port Gibson, MS 39150-4262
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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Participating start date 01/01/2013, termination 4/1/2013, reinstate 10/1/2018
08/02/2018
April 2025
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