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CH07089A SIOUXLAND COMMUNITY HEALTH CENTER (Active)
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Main Details
Name
SIOUXLAND COMMUNITY HEALTH CENTER
Subdivision Name
Siouxland Community Health Center South Sioux City Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-015653
340B ID
CH07089A
Grant Number
H80CS00535
Additional Details
Current Program Status
Active
Registration Date
1/8/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/10/2016
Last Recertification Date
2/18/2025
Contacts
Authorizing Official
Siouxland community Health center
Mark A Donaldson, CEO
(712) 226-9010
Primary Contact
Siouxland Community Health Center
Randall Rouse, Pharmacy Manager
(712) 226-9429
Addresses
Street Address
3410 FUTURES DR
SOUTH SIOUX CITY, NE 68776-3917
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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May 2025
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