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CHC26585-05 Community Health Center of Northeast Oklahoma, Inc. (Active)
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Main Details
Name
Community Health Center of Northeast Oklahoma, Inc.
Subdivision Name
Jay Family Medicine Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-031826
340B ID
CHC26585-05
Grant Number
H80CS26585
Additional Details
Current Program Status
Active
Registration Date
7/8/2021
Participating Start Date
10/1/2021
Participating Approval Date
7/9/2021
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Community Health Center of Northeast Oklahoma, Inc
Janet Mendez, Chief Operating Officer
(918) 257-8029
Primary Contact
Community Health Center of Northeast Oklahoma, Inc.
Shandi Guertin, Informatics and Telehealth Coordinator
(918) 257-8029
Addresses
Street Address
2485 N Main St
Jay, OK 74346-2201
Billing Address
Community Health Center of Northeast Oklahoma, Inc.
21965 Bison Dr.
Afton, OK 74331
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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