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CH05675C NEIGHBORHOOD HEALTHSOURCE (Terminated)
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Main Details
Name
NEIGHBORHOOD HEALTHSOURCE
Subdivision Name
Heritage Seniors Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-011285
340B ID
CH05675C
Grant Number
H80CS00516
Additional Details
Current Program Status
Terminated
Registration Date
4/15/2013
Participating Start Date
7/1/2013
Participating Approval Date
5/22/2013
Last Recertification Date
2/29/2016
Termination Date
Termination Reason
4/1/2016
Site closure
Contacts
Authorizing Official
Neighborhood HealthSource
Steven J. Knutson, Executive Director
(612) 287-2428
Primary Contact
Neighborhood HealthSource
Steven J. Knutson, Executive Director
(612) 287-2428
Addresses
Street Address
1015 4th Avenue N, Ste. 201
Minneapolis, MN 55405-1178
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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