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CH05099AA HEALTHSOURCE OF OHIO, INC. (Active)
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Main Details
Name
HEALTHSOURCE OF OHIO, INC.
Subdivision Name
HealthSource Lebanon
Type
HRSA-Funded Health Center
Site ID
BPS-H80-012809
340B ID
CH05099AA
Grant Number
H80CS00201
Additional Details
Current Program Status
Active
Registration Date
10/8/2014
Participating Start Date
1/1/2015
Participating Approval Date
10/16/2014
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
1231 Columbus Ave UNIT A1
Lebanon, OH 45036-8196
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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April 2025
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