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CH10076A NORTHWEST HUMAN SERVICES, INC. (Active)
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Main Details
Name
NORTHWEST HUMAN SERVICES, INC.
Subdivision Name
WEST SALEM CLINIC
Type
HRSA-Funded Health Center
Site ID
BPS-H80-004239
340B ID
CH10076A
Grant Number
H80CS00148
Additional Details
Current Program Status
Active
Registration Date
7/1/1996
Participating Start Date
7/1/1996
Participating Approval Date
9/8/2004
Last Recertification Date
2/14/2025
Contacts
Authorizing Official
Northwest Human Services, Inc.
Kimberly Ann Leathley, CEO
(503) 588-2831
Primary Contact
NW Human Services
Matthew John Emery, CFO
(503) 588-5828 Ext: 2834
Addresses
Street Address
1233 EDGEWATER AVENUE, NW
SALEM, OR 97304
Billing Address
Northwest Human Services, Inc.
681 Center Street, NE
Salem, OR 97301
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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11/17/08 UPDATED ADDR. (WAS 150 KINGWOOD AVENUE NW)
01/14/2010
May 2025
May 2025
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