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CHC29003-00 NORTH CUSTER HOSPITAL DIS (Active)
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Main Details
Name
NORTH CUSTER HOSPITAL DIS
Subdivision Name
Challis Area Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-015395
340B ID
CHC29003-00
Grant Number
H80CS29003
Additional Details
Current Program Status
Active
Registration Date
1/14/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/10/2016
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Challis Area Health Center
Steve Rembelski, CEO
(208) 879-3035
Primary Contact
Challis Area Health Center
Sharlene Miller, CFO
(208) 879-3027
Addresses
Street Address
611 CLINIC RD
CHALLIS, ID 83226-4824
Billing Address
Challis Area Health Center
P.O. Box 980
Challis, ID 83226
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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