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FQHCLA346B Highland Health Providers Corporation (Terminated)
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Main Details
Name
Highland Health Providers Corporation
Subdivision Name
Highland Health Providers - Lynchburg Medical Center
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-021503
340B ID
FQHCLA346B
Grant Number
LALCS00180
Additional Details
Current Program Status
Terminated
Registration Date
4/16/2018
Participating Start Date
7/1/2018
Participating Approval Date
6/4/2018
Last Recertification Date
2/10/2020
Termination Date
Termination Reason
7/1/2020
Change of covered entity type (non-hospital)
Contacts
Authorizing Official
Highland District Hospital
Meghann Ackley, Chief Financial Officer
(937) 840-6617
Primary Contact
Highland Health Providers
Kelsey Cloud, Clinic Manager
(937) 393-8426
Addresses
Street Address
8900 State Route 134
Lynchburg, OH 45142-9272
Billing Address
Highland Health Providers
1487 N High Street
Suite 102
Hillsboro, OH 45133
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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