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CH07440E DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC. (Active)
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Main Details
Name
DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC.
Subdivision Name
MISSOURI OZARKS COMMUNITY HEALTH
Type
HRSA-Funded Health Center
Site ID
BPS-H80-005201
340B ID
CH07440E
Grant Number
H80CS00457
Additional Details
Current Program Status
Active
Registration Date
1/1/2005
Participating Start Date
1/1/2005
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
804 N HIGHWAY 5
MANSFIELD, MO 65704-7301
Billing Address
DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC. - DBA 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 SHIP TO; 10/10/08 UPDATED MEDICAID #S
01/11/2010
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