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CH05099AJ HEALTHSOURCE OF OHIO INC (Active)
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Main Details
Name
HEALTHSOURCE OF OHIO INC
Subdivision Name
HealthSource Goshen
Type
HRSA-Funded Health Center
Site ID
BPS-H80-035829
340B ID
CH05099AJ
Grant Number
H80CS00201
Additional Details
Current Program Status
Active
Registration Date
2/27/2023
Participating Start Date
4/1/2023
Participating Approval Date
2/28/2023
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
6696 Goshen Rd. STE 324
Goshen, OH 45122-9273
Billing Address
HEALTHSOURCE OF OHIO, INC.
424 WARDS CORNER STE 200
LOVELAND, OH 45140
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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