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CHC28965-05 FORDLAND CLINIC (Active)
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Main Details
Name
FORDLAND CLINIC
Subdivision Name
Blue Eye Elementary
Type
HRSA-Funded Health Center
Site ID
BPS-H80-015501
340B ID
CHC28965-05
Grant Number
H80CS28965
Additional Details
Current Program Status
Active
Registration Date
1/5/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/17/2016
Last Recertification Date
2/17/2025
Contacts
Authorizing Official
Fordland Clinic, Inc.
David Steinmann, CEO
(417) 767-2273 Ext: 2022
Primary Contact
Fordland Clinic, Inc.
Ray Seiberlich, CFO
(417) 767-2273 Ext: 2034
Addresses
Street Address
658 STATE HIGHWAY EE
BLUE EYE, MO 65611-7222
Billing Address
Fordland Clinic
1059 Barton Drive
Fordland, MO 65652-7350
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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