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CH05099Y HEALTHSOURCE OF OHIO, INC. (Active)
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Main Details
Name
HEALTHSOURCE OF OHIO, INC.
Subdivision Name
HealthSource Anderson Ob/Gyn
Type
HRSA-Funded Health Center
Site ID
BPS-H80-017234
340B ID
CH05099Y
Grant Number
H80CS00201
Additional Details
Current Program Status
Active
Registration Date
7/8/2014
Participating Start Date
10/1/2014
Participating Approval Date
7/22/2014
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
HEALTHSOURCE OF OHIO INC
Sam Rotunna, Vice President, Pharmacy Services
(513) 732-5084
Primary Contact
HEALTHSOURCE OF OHIO INC
Lisa Jackson, VP of Marketing and Development
(513) 576-7700
Addresses
Street Address
8000 5 Mile Rd.
Ste 207
Cincinnati, OH 45230
Billing Address
HEALTHSOURCE OF OHIO, INC.
424 WARDS CORNER STE 200
LOVELAND, OH 45140-6966
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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