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CHC00349-00 PRAIRIE COMMUNITY HEALTH INC (Terminated)
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Main Details
Name
PRAIRIE COMMUNITY HEALTH INC
Subdivision Name
FAITH COMMUNITY HLTH CTR
Type
HRSA-Funded Health Center
Site ID
BPS-H80-003586
340B ID
CHC00349-00
Grant Number
H80CS00349
Additional Details
Current Program Status
Terminated
Registration Date
9/8/2009
Participating Start Date
10/1/2009
Participating Approval Date
9/17/2009
Last Recertification Date
3/3/2016
Termination Date
Termination Reason
7/1/2016
Site closure
Contacts
Authorizing Official
Horizon Health Care, Inc.
WADE ERICKSON, CFO
(605) 772-4525
Primary Contact
Horizon Health Care, Inc.
WADE ERICKSON, CFO
(605) 772-4525
Addresses
Street Address
112 N. 2ND AVE, WEST
FAITH, SD 57626-0000
Billing Address
FAITH COMMUNITY HEALTH CENTER
PO BOX 577
FAITH, SD 57626
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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10/13/09 UPDATED ENITY NAME (WAS FAITH COMMUNITY HEALTH CENTER)
01/12/2010
May 2025
May 2025
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