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CH05711J 3RD STREET COMMUNITY CLINIC (Terminated)
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Main Details
Name
3RD STREET COMMUNITY CLINIC
Subdivision Name
Tyger Care
Type
HRSA-Funded Health Center
Site ID
BPS-H80-018572
340B ID
CH05711J
Grant Number
H80CS00581
Additional Details
Current Program Status
Terminated
Registration Date
1/11/2017
Participating Start Date
4/1/2017
Participating Approval Date
1/30/2017
Last Recertification Date
2/9/2018
Termination Date
Termination Reason
1/1/2019
Business decision by the Covered Entity
Contacts
Authorizing Official
Third Street Family Health Services
Brett Toward, Interim CEO
(419) 526-7880
Primary Contact
Third Street Community Clinic
Mary Heflin, Director of Population Health
(419) 526-7879
Addresses
Street Address
124 N. Linden Road
Mansfield, OH 44906-2616
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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June 2025
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