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CH04479Q Primary Health Care Center Of Dade, Inc. (Active)
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Main Details
Name
Primary Health Care Center Of Dade, Inc.
Subdivision Name
Primary Healthcare Center, Mitchell Road
Type
HRSA-Funded Health Center
Site ID
BPS-H80-033806
340B ID
CH04479Q
Grant Number
H80CS00649
Additional Details
Current Program Status
Active
Registration Date
10/13/2023
Participating Start Date
1/1/2024
Participating Approval Date
10/20/2023
Last Recertification Date
3/5/2025
Contacts
Authorizing Official
Primary Healthcare Center
Richard Christman, Chief Executive Officer
(706) 956-2665 Ext: 8549
Primary Contact
Primary Health Care Center of Dade, Inc.
Melanie Forsythe, COO
(706) 620-4494 Ext: 8541
Addresses
Street Address
100 Mitchell Rd
Fort Oglethorpe, GA 30742-3683
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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