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CH05039A NORTHWEST MICHIGAN HEALTH SERVICES (Terminated)
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Main Details
Name
NORTHWEST MICHIGAN HEALTH SERVICES
Subdivision Name
NORTHWEST MICHIGAN HEALTH SERVICES, INC.
Type
HRSA-Funded Health Center
Site ID
BPS-H80-000286
340B ID
CH05039A
Grant Number
H80CS00669
Additional Details
Current Program Status
Terminated
Registration Date
7/1/2002
Participating Start Date
7/1/2002
Participating Approval Date
3/24/2005
Last Recertification Date
2/6/2020
Termination Date
Termination Reason
1/1/2021
Site closure
Contacts
Authorizing Official
Northwest Michigan Health Services
Heidi Britton, Chief Executive Officer
(231) 947-1112
Primary Contact
Northwest Michigan Health Services, Inc.
Gwen Williams, Director of Programs
(231) 861-2130
Addresses
Street Address
6433 EIGHT MILE ROAD
BEAR LAKE, MI 49614
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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