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CHC28349-00 SPRINGVALE HEALTH CENTERS, INC. (Active)
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Main Details
Name
SPRINGVALE HEALTH CENTERS, INC.
Subdivision Name
204 Bellevue St.
Type
HRSA-Funded Health Center
Site ID
BPS-H80-015320
340B ID
CHC28349-00
Grant Number
H80CS28349
Additional Details
Current Program Status
Active
Registration Date
8/17/2021
Participating Start Date
8/18/2021
Participating Approval Date
8/18/2021
Last Recertification Date
2/12/2025
Contacts
Authorizing Official
SpringVale Health Centers
Joseph Boroski, Chief Executive Officer
(330) 343-6631
Primary Contact
SPRINGVALE HEALTH CENTERS, INC.
NICOLE LEWIS, DIRECTOR OF PHARMACY
(330) 365-1085
Addresses
Street Address
204 S Bellevue Ave
Dover, OH 44622-9405
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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Participating from effective date: (1/1/2016) until terminated effective date: (04/01/2018), reinstatement effective date: (08/18/2021).
08/18/2021
Participating from effective date: (1/1/2016) until terminated effective date: (04/01/2021), reinstatement effective date: (08/18/2021)
08/18/2021
April 2025
April 2025
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