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CH10817S Dirne Health Centers, Inc. (Terminated)
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Main Details
Name
Dirne Health Centers, Inc.
Subdivision Name
Heritage Health - 1221 West Ironwood Suite 100
Type
HRSA-Funded Health Center
Site ID
BPS-H80-032643
340B ID
CH10817S
Grant Number
H80CS02331
Additional Details
Current Program Status
Terminated
Registration Date
1/3/2022
Participating Start Date
4/1/2022
Participating Approval Date
1/4/2022
Last Recertification Date
2/20/2024
Termination Date
Termination Reason
4/1/2025
Site closure
Contacts
Authorizing Official
Heritage Health
Michael Baker, CEO
(208) 292-0256
Primary Contact
Dirne Health Centers, Inc
Monica Graybeal, Director of Pharmacy
(208) 292-0662
Addresses
Street Address
1221 W Ironwood Dr Ste 100
Coeur D Alene, ID 83814-1402
Billing Address
Dirne Health Centers, Inc.
PO Box 1387
Hayden, ID 83835
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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