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CH05099A HEALTHSOURCE OF OHIO, INC. (Terminated)
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Main Details
Name
HEALTHSOURCE OF OHIO, INC.
Subdivision Name
RIPLEY
Type
HRSA-Funded Health Center
Site ID
BPS-H80-000229
340B ID
CH05099A
Grant Number
H80CS00201
Additional Details
Current Program Status
Terminated
Registration Date
10/1/1998
Participating Start Date
10/1/1998
Participating Approval Date
6/16/2005
Last Recertification Date
1/31/2017
Termination Date
Termination Reason
7/1/2017
Site closure
Contacts
Authorizing Official
HealthSource of Ohio
KIM PATTON, CEO
(513) 576-7700
Primary Contact
JEFF LUND, ACCOUNTANT
(513) 576-7700 Ext: 3644
Addresses
Street Address
14 N 2nd St
Ripley, OH 45167-1101
Billing Address
HEALTHSOURCE OF OHIO
5400 DUPONT CIRCLE, SUITE A
MILFORD, OH 45150
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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4/5/11 ADDED BILL-TO ADD, UPDATED SUB-DIV NAME (WAS RIPLEY FAMILY HEALTH CENTER); 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, UPDATED SUB-DIV NAME (WAS RIPLEY FAMILY HEALTH CENTER); 12/3/07 UPDATED ENTITY NAME (WAS SOUTHERN OHIO HEALTH SERVICES NETWORK)
04/05/2011
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