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CH05711P THIRD STREET COMMUNITY CLINIC INC (Active)
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Main Details
Name
THIRD STREET COMMUNITY CLINIC INC
Subdivision Name
Community Counseling and Wellness Centers-Marion
Type
HRSA-Funded Health Center
Site ID
BPS-H80-036911
340B ID
CH05711P
Grant Number
H80CS00581
Additional Details
Current Program Status
Active
Registration Date
10/13/2023
Participating Start Date
1/1/2024
Participating Approval Date
10/18/2023
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
320 Executive Dr
Marion, OH 43302-6310
Billing Address
Third Street Community Clinic, Inc
1404 Park Ave W
Suite 2
Mansfield, OH 44906
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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June 2025
June 2025
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