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CH10817M DIRNE HEALTH CENTERS, INC. (Terminated)
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Main Details
Name
DIRNE HEALTH CENTERS, INC.
Subdivision Name
Heritage Health Mullan Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-014839
340B ID
CH10817M
Grant Number
H80CS02331
Additional Details
Current Program Status
Terminated
Registration Date
10/6/2015
Participating Start Date
1/1/2016
Participating Approval Date
10/16/2015
Last Recertification Date
2/8/2017
Termination Date
Termination Reason
4/1/2018
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
117 Terrill Loop
Mullan, ID 83846
Billing Address
Heritage Health
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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