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CHC30718-02 SIGNATURE HEALTH, INC. (Terminated)
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Main Details
Name
SIGNATURE HEALTH, INC.
Subdivision Name
Signature Health, Inc. Willoughby Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-019105
340B ID
CHC30718-02
Grant Number
H80CS30718
Additional Details
Current Program Status
Terminated
Registration Date
1/17/2017
Participating Start Date
4/1/2017
Participating Approval Date
1/30/2017
Last Recertification Date
2/11/2023
Termination Date
Termination Reason
4/1/2024
Site closure
Contacts
Authorizing Official
Signature Health Inc.
Jonathan Albert Lee, CEO
(440) 953-9999 Ext: 705133
Primary Contact
Signature Health, Inc
Shannon Majoras, Chief Compliance Officer
(440) 578-8200
Addresses
Street Address
38882 Mentor Avenue
Willoughby, OH 44094-7875
Billing Address
Signature Health, Inc
7232 Justin Way
Mentor, OH 44060
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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