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CH09289I NORTH COUNTRY HEALTHCARE, INC. (Terminated)
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Main Details
Name
NORTH COUNTRY HEALTHCARE, INC.
Subdivision Name
NORTH COUNTRY CHC-SELIGMAN SITE
Type
HRSA-Funded Health Center
Site ID
BPS-H80-006323
340B ID
CH09289I
Grant Number
H80CS00651
Additional Details
Current Program Status
Terminated
Registration Date
5/6/2010
Participating Start Date
7/1/2010
Participating Approval Date
5/11/2010
Last Recertification Date
2/15/2023
Termination Date
Termination Reason
4/1/2024
Site closure
Contacts
Authorizing Official
North Country HealthCare
ANNE NEWLAND, CEO
(928) 522-9564
Primary Contact
North Country HealthCare
KIMBERLY CHEN, DIRECTOR OF PHARMACY
(928) 522-9572
Addresses
Street Address
22585 W. OAK STREET
SELIGMAN, AZ 86337-0776
Billing Address
NORTH COUNTRY HEALTHCARE
PO BOX 3630
FLAGSTAFF, AZ 86003
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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