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CH101289A MAT SU HEALTH SERVICES INC (Terminated)
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Main Details
Name
MAT SU HEALTH SERVICES INC
Subdivision Name
Burchell High School
Type
HRSA-Funded Health Center
Site ID
BPS-H80-014704
340B ID
CH101289A
Grant Number
H80CS04435
Additional Details
Current Program Status
Terminated
Registration Date
1/12/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/17/2016
Last Recertification Date
2/5/2021
Termination Date
Termination Reason
4/1/2022
Site closure
Contacts
Authorizing Official
Mat-Su Health Services, Inc.
Kevin Munson, Chief Executive Officer
(907) 376-2411
Primary Contact
Mat-Su Health Services, Inc.
Linda Reimer, Compliance Officer
(907) 376-2411
Addresses
Street Address
1775 W PARKS HWY
WASILLA, AK 99654-6935
Billing Address
Mat-Su Health Services, Inc.
1363 W. Spruce Ave.
Wasilla, AK 99654-5327
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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