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CH101086A WATERFALL CLINIC INC (Active)
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Main Details
Name
WATERFALL CLINIC INC
Subdivision Name
Waterfall School Based Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-007096
340B ID
CH101086A
Grant Number
H80CS08771
Additional Details
Current Program Status
Active
Registration Date
3/3/2010
Participating Start Date
4/1/2010
Participating Approval Date
3/9/2010
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
826 S. 11th St
Coos Bay, OR 97420-1328
Billing Address
WATERFALL CLINIC, INC.
1890 WAITE STREET SUITE 1
NORTH BEND, OR 97459
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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June 2025
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