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FQHCLA257A MARIAS HEALTHCARE SERVICES, INC. (Terminated)
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Main Details
Name
MARIAS HEALTHCARE SERVICES, INC.
Subdivision Name
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-009854
340B ID
FQHCLA257A
Grant Number
LALCS00043
Additional Details
Current Program Status
Terminated
Registration Date
4/29/2010
Participating Start Date
7/1/2010
Participating Approval Date
6/9/2010
Last Recertification Date
1/28/2015
Termination Date
Termination Reason
1/1/2016
Change of covered entity type
Contacts
Authorizing Official
Marias Healthcare Services
Jamie F Brownell, CEO
(406) 434-3110
Primary Contact
Marias Healthcare Services
Jamie F Brownell, CEO
(406) 434-3110
Addresses
Street Address
422 MONTANA
VALIER, MT 59486
Billing Address
MARIAS HEALTHCARE SERVICES, INC.
PO BOX 990
SHELBY, MT 59474
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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