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CHC22690-05 MACOUPIN, COUNTY OF (Active)
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Main Details
Name
MACOUPIN, COUNTY OF
Subdivision Name
Oakland Avenue Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-035727
340B ID
CHC22690-05
Grant Number
H80CS22690
Additional Details
Current Program Status
Active
Registration Date
4/4/2023
Participating Start Date
7/1/2023
Participating Approval Date
4/4/2023
Last Recertification Date
2/18/2025
Contacts
Authorizing Official
Macopupin County Public Health Department
Lori J Sanson, CFO
(217) 930-2282
Primary Contact
Macoupin County Public Health Dep
Christy Blank, Chief Executive Officer
(217) 930-2283
Addresses
Street Address
205 Oakland Ave
Carlinville, IL 62626-1921
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
April 2025
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