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CH051278R HEARTLAND INTERNATIONAL HEALTH CENTERS (Terminated)
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Main Details
Name
HEARTLAND INTERNATIONAL HEALTH CENTERS
Subdivision Name
Heartland Health Center-Niles North
Type
HRSA-Funded Health Center
Site ID
BPS-H80-015139
340B ID
CH051278R
Grant Number
H80CS00215
Additional Details
Current Program Status
Terminated
Registration Date
1/8/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/11/2016
Last Recertification Date
1/31/2017
Termination Date
Termination Reason
4/1/2017
Site closure
Contacts
Authorizing Official
Heartland International Health Center
Huell Collier, Billing and Credentialing Manager
(773) 296-7544
Primary Contact
Heartland International Health Center
Huell Collier, Billing and Credentialing Manager
(773) 296-7544
Addresses
Street Address
9800 Lawler Ave
Skokie, IL 60077-1215
Billing Address
Heartland International Health Center
3048 N Wilton Ave
2nd Floor
Chicago, IL 60657-6710
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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