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RWII43201D EQUITAS HEALTH (Terminated)
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Main Details
Name
EQUITAS HEALTH
Subdivision Name
MANSFIELD OFFICE
Type
Ryan White Part B
340B ID
RWII43201D
Grant Number
X07HA00016
Additional Details
Current Program Status
Terminated
Registration Date
10/15/2014
Participating Start Date
1/1/2015
Participating Approval Date
12/10/2014
Last Recertification Date
2/20/2018
Time Period the Assistance was Received
Termination Date
Termination Reason
4/1/2019
Business decision by the Covered Entity
Contacts
Authorizing Official
Equitas Health
Peggy Anderson, COO
(614) 340-6691
Primary Contact
Equitas Health
Anna Wuerth, Sr. Director of Grants Implementation and Integration
(614) 340-6754
Addresses
Street Address
410 PARK AVE. WEST
SUITE 5
MANSFIELD, OH 44906
Billing Address
EQUITAS HEALTH
4400 NORTH HIGH STREET
SUITE 300
COLUMBUS, OH 43214
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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