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CH05190B Heartland Alliance Health, Inc. (Active)
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Main Details
Name
Heartland Alliance Health, Inc.
Subdivision Name
HEARTLAND ALLIANCE HEALTH - ENGLEWOOD
Type
HRSA-Funded Health Center
Site ID
BPS-H80-021399
340B ID
CH05190B
Grant Number
H80CS00111
Additional Details
Current Program Status
Active
Registration Date
4/2/2018
Participating Start Date
7/1/2018
Participating Approval Date
4/4/2018
Last Recertification Date
1/29/2024
Contacts
Authorizing Official
Heartland Alliance Health
John Church, Interim Executive Director
(559) 349-5652
Primary Contact
Heartland Alliance Health
Mark Daniel Calvert, Director of Specialty Business
(773) 351-3351
Addresses
Street Address
5501 S HALSTED ST
CHICAGO, IL 60621-2229
Billing Address
Heartland Alliance Health, Inc.
4730 N Winthrop Ave
Chicago, IL 60640-5034
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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Last Recertification Date: 3/24/2025
03/27/2025
April 2025
April 2025
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