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CH07440A 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 HEALTH
Type
HRSA-Funded Health Center
Site ID
BPS-H80-001447
340B ID
CH07440A
Grant Number
H80CS00457
Additional Details
Current Program Status
Active
Registration Date
4/1/2004
Participating Start Date
4/1/2004
Participating Approval Date
3/25/2004
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
504 W. Broadway Ave.
AVA, MO 65608-1359
Billing Address
Missouri Ozarks Community Health
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 MEDICAID #S; 10/7/2008 ADDED IN HOUSE PHARMACY AS SHIPPING ADDR.
01/11/2010
April 2025
April 2025
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