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CH051833L Heartland Community Health Clinic DBA Heartland Health Services - Olt (Active)
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Main Details
Name
Heartland Community Health Clinic DBA Heartland Health Services - Olt
Subdivision Name
Heartland Health Services - Olt
Type
HRSA-Funded Health Center
Site ID
BPS-H80-029878
340B ID
CH051833L
Grant Number
H80CS02457
Additional Details
Current Program Status
Active
Registration Date
10/5/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/18/2017
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Heartland Health Services
Dewitt Harrell, CEO
(309) 680-7657
Primary Contact
Heartland Health Services
Tony Bartlett, CFO
(309) 680-7612
Addresses
Street Address
19 Olt Ave
Pekin, IL 61554
Billing Address
Heartland Health Services
2214 N. University Street
Peoria, IL 61604
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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