340B Drug Pricing Program Database
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CH05099L HEALTHSOURCE OF OHIO, INC. (Active)
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Main Details
Name
HEALTHSOURCE OF OHIO, INC.
Subdivision Name
HealthSource Batavia Family Practice & Pharmacy
Type
HRSA-Funded Health Center
Site ID
BPS-H80-009599
340B ID
CH05099L
Grant Number
H80CS00201
Additional Details
Current Program Status
Active
Registration Date
10/1/1998
Participating Start Date
10/1/1998
Participating Approval Date
6/16/2005
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
HEALTHSOURCE OF OHIO INC
Sam Rotunna, Vice President, Pharmacy Services
(513) 732-5084
Primary Contact
HEALTHSOURCE OF OHIO INC
Lisa Jackson, VP of Marketing and Development
(513) 576-7700
Addresses
Street Address
2055 Hospital Dr STE 130
Batavia, OH 45103-1978
Billing Address
HEALTHSOURCE OF OHIO, INC.
424 WARDS CORNER STE 200
LOVELAND, OH 45140-6966
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History
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4/5/11 ADDED BILL-TO ADD; 3/16/11 ADDED SHIP ADD; 11/1/10 ADDED NPI#; 8/3/10 UPDATED ADDR (WAS 2245 BAUER ROAD, SUITE A, BATAVIA, 45103) AND SUBD NAME (WAS BATAVIA FAMILY PRACTICE); 12/3/07 UPDATED ENTITY NAME (WAS SOUTHERN OHIO HEALTH SERVICES NETWORK) 3/7/12-Changed contact person (was MISSY HANZEL)
03/07/2012
4/5/11 ADDED BILL-TO ADD; 3/16/11 ADDED SHIP ADD; 11/1/10 ADDED NPI#; 8/3/10 UPDATED ADDR (WAS 2245 BAUER ROAD, SUITE A, BATAVIA, 45103) AND SUBD NAME (WAS BATAVIA FAMILY PRACTICE); 12/3/07 UPDATED ENTITY NAME (WAS SOUTHERN OHIO HEALTH SERVICES NETWORK)
04/05/2011
April 2025
April 2025
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