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CH051833N Heartland Community Health Clinic DBA Heartland Health Services (Active)
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Main Details
Name
Heartland Community Health Clinic DBA Heartland Health Services
Subdivision Name
Tazwood
Type
HRSA-Funded Health Center
Site ID
BPS-H80-024953
340B ID
CH051833N
Grant Number
H80CS02457
Additional Details
Current Program Status
Active
Registration Date
7/1/2019
Participating Start Date
10/1/2019
Participating Approval Date
7/11/2019
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Heartland Health Services
Dewitt Harrell, CEO
(309) 680-7657
Primary Contact
Heartland Health Services
Tony Bartlett, CFO
(309) 680-7612
Addresses
Street Address
3248 Vandever Ave Ste B
Pekin, IL 61554
Billing Address
Heartland Community Health Clinic DBA: Heartland Health Services
2214 N. University St
Peoria, IL 61604
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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