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CH05711B 3RD STREET COMMUNITY CLINIC (Terminated)
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Main Details
Name
3RD STREET COMMUNITY CLINIC
Subdivision Name
Mansfield Family Health - Admin Office
Type
HRSA-Funded Health Center
Site ID
BPS-H80-011117
340B ID
CH05711B
Grant Number
H80CS00581
Additional Details
Current Program Status
Terminated
Registration Date
1/11/2013
Participating Start Date
4/1/2013
Participating Approval Date
2/25/2013
Last Recertification Date
2/26/2021
Termination Date
Termination Reason
4/1/2022
Site closure
Contacts
Authorizing Official
Third Street Family Health Services
Brett Toward, CEO/CMO
(419) 522-6191
Primary Contact
Third Street Family Health Services
Barbara Sullinger, CFO
(419) 527-7867
Addresses
Street Address
741 Scholl Road, Suite A
Mansfield, OH 44907
Billing Address
Third Street Community Clinic
600 W Third St
Mansfield, OH 44906
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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