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CH051833M Heartland Community Health Clinic (Terminated)
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Main Details
Name
Heartland Community Health Clinic
Subdivision Name
Heartland Community Health Clinic DBA: Heartland Health Services - University
Type
HRSA-Funded Health Center
Site ID
BPS-H80-013947
340B ID
CH051833M
Grant Number
H80CS02457
Additional Details
Current Program Status
Terminated
Registration Date
10/6/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/18/2017
Last Recertification Date
Termination Date
Termination Reason
1/1/2018
Other
Contacts
Authorizing Official
Heartland Community Health Clinic DBA Heartland Health Services
CHARLES BANDOIAN, CEO
(309) 680-7657
Primary Contact
Health Community Health Clinic DBA Heartland Health Services
Marjorie Parent, Vice President of Clinical Operations
(309) 680-7614
Addresses
Street Address
2214 N UNIVERSITY ST
PEORIA, IL 61604-3221
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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