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CH081150J COAL COUNTRY COMMUNITY HEALTH CENTER (Active)
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Main Details
Name
COAL COUNTRY COMMUNITY HEALTH CENTER
Subdivision Name
Coal Country Community Health Center - Hazen Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-019528
340B ID
CH081150J
Grant Number
H80CS09469
Additional Details
Current Program Status
Active
Registration Date
7/7/2016
Participating Start Date
10/1/2016
Participating Approval Date
7/28/2016
Last Recertification Date
2/12/2025
Contacts
Authorizing Official
Coal Country Community Health Center
Kurt V Waldbillig, CEO
(701) 873-6008
Primary Contact
Coal Country Community Health Center
Brooke G Borlaug, Clinic Director
(701) 873-7411
Addresses
Street Address
510 8th Ave. NE
Hazen, ND 58545
Billing Address
Coal Country Community Health Center
1312 Highway 49 N
Beulah, ND 58523
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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