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CH070890 SIOUXLAND COMMUNITY HEALTH CENTER (Active)
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Main Details
Name
SIOUXLAND COMMUNITY HEALTH CENTER
Subdivision Name
SIOUXLAND COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-005051
340B ID
CH070890
Grant Number
H80CS00535
Additional Details
Current Program Status
Active
Registration Date
12/1/1992
Participating Start Date
12/1/1992
Participating Approval Date
12/1/1992
Last Recertification Date
2/17/2025
Contacts
Authorizing Official
Siouxland community Health center
Mark A Donaldson, CEO
(712) 226-9010
Primary Contact
Siouxland
Shelby Petersen, Director of Clinic Operations, RN, BSN
(712) 226-9014
Addresses
Street Address
1021 Nebraska St
Sioux City, IA 51105-1436
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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7/20/07 CONVERTED ADDR LINE 2 TO BILL TO
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