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CH057110 THIRD STREET COMMUNITY CLINIC (Active)
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Main Details
Name
THIRD STREET COMMUNITY CLINIC
Subdivision Name
Third Street Community Clinic, Inc
Type
HRSA-Funded Health Center
Site ID
BPS-H80-001276
340B ID
CH057110
Grant Number
H80CS00581
Additional Details
Current Program Status
Active
Registration Date
10/1/2001
Participating Start Date
10/1/2001
Participating Approval Date
10/8/2003
Last Recertification Date
2/21/2025
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
600 W 3rd St
Mansfield, OH 44906-2633
Billing Address
Third Street Community Clinic, Inc
1404 Park Ave West
Suite 2
Mansfield, OH 44906
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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ID CORRECTION - REPLACES FQHCLA096/CH57110
02/28/2011
April 2025
April 2025
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