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CH07440J DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC. (Active)
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Main Details
Name
DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC.
Subdivision Name
Missouri Ozarks Community Health Licking Medical
Type
HRSA-Funded Health Center
Site ID
BPS-H80-028270
340B ID
CH07440J
Grant Number
H80CS00457
Additional Details
Current Program Status
Active
Registration Date
4/9/2020
Participating Start Date
7/1/2020
Participating Approval Date
4/13/2020
Last Recertification Date
2/25/2025
Contacts
Authorizing Official
Missouri Ozarks Community Health
Randall L Gann, CEO
(417) 683-5739
Primary Contact
Douglas County Public Health Services Group, INc.
Jennifer Heinlein, COO
(417) 683-5739 Ext: 1111
Addresses
Street Address
135 College Ave
Licking, MO 65542-9878
Billing Address
Missouri Ozarks Community Health
PO Box 1359
Ava, MO 65608
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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