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CH092890 NORTH COUNTRY HEALTHCARE, INC. (Active)
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Main Details
Name
NORTH COUNTRY HEALTHCARE, INC.
Subdivision Name
NORTH COUNTRY - FLAGSTAFF CLINIC
Type
HRSA-Funded Health Center
Site ID
BPS-H80-003833
340B ID
CH092890
Grant Number
H80CS00651
Additional Details
Current Program Status
Active
Registration Date
7/1/1998
Participating Start Date
7/1/1998
Participating Approval Date
10/5/2008
Last Recertification Date
2/18/2025
Contacts
Authorizing Official
North Country HealthCare
ANNE NEWLAND, CEO
(928) 522-9564
Primary Contact
North Country HealthCare
Andrew Kurtz, Director of Pharmacy
(928) 522-1073
Addresses
Street Address
2920 N 4th St
Flagstaff, AZ 86004-1816
Billing Address
NORTH COUNTRY HEALTHCARE
PO BOX 3630
FLAGSTAFF, AZ 86003
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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5/11/10 ENTITY NAME CHANGE (WAS NORTH COUNTRY COMMUNITY HEALTH CTR) 10/5/08 UPDATED ADDR. (WAS 2500 N ROSE)
05/13/2010
April 2025
April 2025
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