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CH05847H COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC. (Active)
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Main Details
Name
COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.
Subdivision Name
PrimaryOne Health 1500 East 17th Avenue
Type
HRSA-Funded Health Center
Site ID
BPS-H80-001399
340B ID
CH05847H
Grant Number
H80CS00118
Additional Details
Current Program Status
Active
Registration Date
4/1/1999
Participating Start Date
4/1/1999
Participating Approval Date
6/14/2004
Last Recertification Date
2/19/2025
Contacts
Authorizing Official
PrimaryOne Health
Nichole Gomez Otayco, COO
(217) 273-7718
Primary Contact
PrimaryOne Health
Rebecca Williamson, 340BProgram Manager
(614) 859-1904
Addresses
Street Address
1500 E 17th Ave
Columbus, OH 43219-1002
Billing Address
COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.
2780 Airport Drive, Suite 100
Columbus, OH 43219
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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CORRECTED ENTITY NAME, CONTACT INFO, ADDED BILL TO. 6/21/11 - CHANGED BILLING ADDRESS FROM 600 WEST SPRING STREET-REAR 2. CHANGED AUTHORIZING OFFICIAL FROM CARL WALTERS AND CONTACT FROM MARY LOVE.
06/21/2011
CORRECTED ENTITY NAME, CONTACT INFO, ADDED BILL TO. 6/21/11 - CHANGED BILLING ADDRESS FROM 600 WEST SPRING STREET-REAR 2. CHANGED AUTHORIZING OFFICIAL FROM CARL WALTERS AND CONTACT FROM MARY LOVE.
06/21/2011
April 2025
April 2025
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