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CH1010860 WATERFALL CLINIC INC (Active)
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Main Details
Name
WATERFALL CLINIC INC
Subdivision Name
WATERFALL CLINIC, INC.
Type
HRSA-Funded Health Center
Site ID
BPS-H80-004201
340B ID
CH1010860
Grant Number
H80CS08771
Additional Details
Current Program Status
Active
Registration Date
11/23/2007
Participating Start Date
1/1/2008
Participating Approval Date
11/27/2007
Last Recertification Date
2/18/2025
Contacts
Authorizing Official
Waterfall Clinic, Inc.
Lance Nelson, CEO
(541) 756-6232
Primary Contact
Waterfall Community Health Ce
Justin Casey, Chief Operating Officer
(541) 756-6232 Ext: 174
Addresses
Street Address
1890 Waite St STE 1
North Bend, OR 97459-1229
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
April 2025
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