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CH05099AG HEALTHSOURCE OF OHIO, INC. (Active)
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Main Details
Name
HEALTHSOURCE OF OHIO, INC.
Subdivision Name
HealthSource Williamsburg
Type
HRSA-Funded Health Center
Site ID
BPS-H80-030893
340B ID
CH05099AG
Grant Number
H80CS00201
Additional Details
Current Program Status
Active
Registration Date
8/17/2020
Participating Start Date
10/1/2020
Participating Approval Date
8/25/2020
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
HEALTHSOURCE OF OHIO INC
Sam Rotunna, Vice President, Pharmacy Services
(513) 732-5084
Primary Contact
HEALTHSOURCE OF OHIO INC
Lisa Jackson, VP of Marketing and Development
(513) 576-7700
Addresses
Street Address
500 S 5th St Ste 202
Williamsburg, OH 45176-1017
Billing Address
HEALTHSOURCE OF OHIO, INC.
424 Wards Corner STE 200
Loveland, OH 45140-6966
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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