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CH05039B NORTHWEST MICHIGAN HEALTH SERVICES, INC (Active)
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Main Details
Name
NORTHWEST MICHIGAN HEALTH SERVICES, INC
Subdivision Name
Northwest Michigan Health Services, Inc.
Type
HRSA-Funded Health Center
Site ID
BPS-H80-000129
340B ID
CH05039B
Grant Number
H80CS00669
Additional Details
Current Program Status
Active
Registration Date
4/1/2002
Participating Start Date
4/1/2002
Participating Approval Date
3/24/2005
Last Recertification Date
2/28/2025
Contacts
Authorizing Official
Northwest Michigan Health Services
Heidi Britton, Chief Executive Officer
(231) 947-1112
Primary Contact
Northwest Michigan Health Services, Inc.
Kimberly A Corliss, Director of Administrative Operations
(231) 861-2130
Addresses
Street Address
119 S State St
Shelby, MI 49455-1243
Billing Address
Northwest Michigan Health Services, Inc.
10767 E. Traverse Hwy
Traverse City, MI 49684
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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3/24/05 - ADMIN CORRECTION - REPLACES MH05039B
04/01/2002
April 2025
April 2025
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