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CH09289S NORTH COUNTRY HEALTHCARE, INC. (Active)
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Main Details
Name
NORTH COUNTRY HEALTHCARE, INC.
Subdivision Name
North Country - Kingman Integration
Type
HRSA-Funded Health Center
Site ID
BPS-H80-019440
340B ID
CH09289S
Grant Number
H80CS00651
Additional Details
Current Program Status
Active
Registration Date
4/12/2017
Participating Start Date
7/1/2017
Participating Approval Date
4/21/2017
Last Recertification Date
2/25/2025
Contacts
Authorizing Official
North Country HealthCare
ANNE NEWLAND, CEO
(928) 522-9564
Primary Contact
North Country HealthCare
Andrew Kurtz, Director of Pharmacy
(928) 522-1073
Addresses
Street Address
3505 WESTERN AVE Ste B
KINGMAN, AZ 86409-3071
Billing Address
NORTH COUNTRY HEALTHCARE
PO BOX 3630
FLAGSTAFF, AZ 86003
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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