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FQHCLA271 FAMILY HEALTH CARE OF NORTHWEST OHIO, INC (Terminated)
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Main Details
Name
FAMILY HEALTH CARE OF NORTHWEST OHIO, INC
Subdivision Name
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-012293
340B ID
FQHCLA271
Grant Number
LALCS00027
Additional Details
Current Program Status
Terminated
Registration Date
11/23/2010
Participating Start Date
1/1/2011
Participating Approval Date
11/24/2010
Last Recertification Date
2/9/2015
Termination Date
Termination Reason
4/1/2016
Change of covered entity type
Contacts
Authorizing Official
Family Health Care of Northwest Ohio, Inc.
Jennifer L Smith, CEO
(419) 238-6747 Ext: 103
Primary Contact
Family Health Care of Northwest Ohio, Inc.
Jennifer L Smith, CEO
(419) 238-6747 Ext: 103
Addresses
Street Address
1052 S Washington St
VAN WERT, OH 45891
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
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