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CH10817J DIRNE HEALTH CENTERS, INC. (Terminated)
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Main Details
Name
DIRNE HEALTH CENTERS, INC.
Subdivision Name
Dirne CHC Physical Therapy
Type
HRSA-Funded Health Center
Site ID
BPS-H80-012743
340B ID
CH10817J
Grant Number
H80CS02331
Additional Details
Current Program Status
Terminated
Registration Date
10/14/2014
Participating Start Date
1/1/2015
Participating Approval Date
10/23/2014
Last Recertification Date
2/12/2015
Termination Date
Termination Reason
1/1/2016
Site closure
Contacts
Authorizing Official
Heritage Health
Michael Baker, CEO
(208) 292-0256
Primary Contact
Dirne Health Centers Inc DBA Heritage Health
Mark Hampe, CFO
(208) 262-0252
Addresses
Street Address
610 W Hubbard St
Coeur D Alene, ID 83814-2285
Billing Address
Dirne Health Centers, Inc.
PO BOX 3648
Coeur d Alene, ID 83816
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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