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CH05039D NORTHWEST MICHIGAN HEALTH SERVICES, INC (Active)
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Main Details
Name
NORTHWEST MICHIGAN HEALTH SERVICES, INC
Subdivision Name
Northwest Michigan Health Services, Inc.
Type
HRSA-Funded Health Center
Site ID
BPS-H80-032962
340B ID
CH05039D
Grant Number
H80CS00669
Additional Details
Current Program Status
Active
Registration Date
7/7/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/13/2017
Last Recertification Date
2/28/2025
Contacts
Authorizing Official
Northwest Michigan Health Services
Heidi Britton, Chief Executive Officer
(231) 947-1112
Primary Contact
Northwest Michigan Health Services, Inc.
Kimberly A Corliss, Director of Administrative Operations
(231) 861-2130
Addresses
Street Address
148 W Parkdale Ave
Manistee, MI 49660-1128
Billing Address
Northwest Michigan Health Services Inc
10767 E. Traverse Hwy.
Traverse City, MI 49684
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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