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CH07440B DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC. (Active)
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Main Details
Name
DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC.
Subdivision Name
DOUGLAS COUNTY PUBLIC HLTH SRV. GROUP
Type
HRSA-Funded Health Center
Site ID
BPS-H80-003085
340B ID
CH07440B
Grant Number
H80CS00457
Additional Details
Current Program Status
Active
Registration Date
4/1/2004
Participating Start Date
4/1/2004
Participating Approval Date
12/7/2004
Last Recertification Date
2/25/2025
Contacts
Authorizing Official
Missouri Ozarks Community Health
Randall L Gann, CEO
(417) 683-5739
Primary Contact
Douglas County Public Health Services Group, INc.
Jennifer Heinlein, COO
(417) 683-5739 Ext: 1111
Addresses
Street Address
87 Elm Street
Gainesville, MO 65655
Billing Address
DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC. - DOUGLAS COUNTY CHC CLINIC
PO BOX 1359
AVA, MO 65608
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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10/10/08 ADDED SHIP TO; 10/10/08 UPDATED MEDICAID #S
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