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CH05711L THIRD STREET COMMUNITY CLINIC (Active)
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Main Details
Name
THIRD STREET COMMUNITY CLINIC
Subdivision Name
Bucyrus Health and Wellness Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-030065
340B ID
CH05711L
Grant Number
H80CS00581
Additional Details
Current Program Status
Active
Registration Date
1/14/2020
Participating Start Date
4/1/2020
Participating Approval Date
1/21/2020
Last Recertification Date
2/24/2025
Contacts
Authorizing Official
Third Street Community Clinic
Peggy Anderson, CEO
(419) 526-7880
Primary Contact
Third Street Community Clinic
Jason Bilyj, Director of Pharmacy
(419) 527-4105
Addresses
Street Address
2458 Stetzer Rd
Unit A
Bucyrus, OH 44820-2066
Billing Address
Third Street Community Clinic, Inc
1404 Park Ave W
Suite 2
Mansfield, OH 44906
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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June 2025
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